RN Senior Medical Reviewer - United States - Remote

We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines. · Review medically complex claims, pre-authorization reque ...

We are looking for freelance medical reviewers who will assess and improve the medical accuracy of our content. · ...

· At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sec ...

We are seeking experienced physicians to conduct independent case reviews for the Department of Veterans Affairs (VA). This role involves evaluating medical cases to assess quality of care and adherence to standards. · Conduct objective medical case reviews using standardized ass ...

· Overview · Empower AI is AI for government. Empower AI gives federal agency leaders the tools to elevate the potential of their workforce with a direct path for meaningful transformation. Headquartered in Reston, Va., Empower AI leverages three decades of experience solving co ...

We are building software infrastructure to make healthcare more modern. We're looking for people who share our mission to heal a fragmented system. · ...

+We are building a new kind of biotech company that maintains its roots as a science-based start-up and pushes our commitment to innovate across all corners of our business. · +Lead an indication sub-team of Medical Reviewers within the US Medical Review Community. · Provide solu ...

We're excited you're considering an opportunity with us. Responsible for working in collaboration with the Medical Director on driving the decrease in care variance, to ensure timely discharges, and to refer members to other plan resources to meet their care conditions. · ...

About MMRO is an established URAC-accredited Independent Review Organization (IRO) that provides objective evidence-based medical peer reviews nationwide. We are currently seeking Board-Certified Orthopedic Surgery Physicians to join our network of sub-contracted Physician Review ...

This position will report to the Claims Manager, playing a unique and important role in our mission to change healthcare for the better. Experience in the healthcare industry and critical thinking skills will help the organization build an effective and efficient claims team. · T ...

We are seeking a motivated Regulatory Affairs Consultant – Advertising & Promotion to join Parexel and work as a trusted partner within a major client engagement. · Key Responsibilities · Review and approve advertising and promotional materials. · Provide regulatory guidance to c ...

To ensure accurate and appropriate gathering of information into the coding classification systems to meet departmental hospital anbd outside agency requirements. · ...

· Ocular Therapeutix, Inc. (NASDAQ:OCUL) is a biopharmaceutical company focused on the formulation, development, and commercialization of innovative therapies for diseases and conditions of the eye using its proprietary bioresorbable hydrogel-based formulation technology, ELUTYX ...

The Director Medical Information will lead and manage planning and execution of Medical Information activities and materials for Cristcots portfolio. This critical role will lead creation of standard response documents to requests for medical information establish and manage stan ...

We are seeking a detail-oriented and motivated Entry-Level Accountant (Level 2) to support core accounting operations, with a strong focus on project accounting and revenue recognition. · This role partners closely with business units and project teams to ensure accurate financia ...

To ensure accurate and appropriate gathering of information into the coding classification systems to meet departmental hospital outside agency requirements this includes ensuring appropriate reimbursement compliance charging with various coding guidelines regulatory agencies res ...

The Supervisor of Authorization Services will oversee the authorization department providing leadership and guidance to processes that ensure the department is efficiently meeting the needs of the departments we support.They will monitor staffing needs analyze medical records for ...

The Prior Authorization Clinician is responsible for reviewing all proposed hospitalization services for medical necessity to ensure members receive appropriate care. · We are committed to diversity and inclusion of staff among our employees. ...

This position is responsible for obtaining authorizations for elective infusions and injections to financially clear patients and ensure reimbursement for the organization. ...

We're excited you're considering an opportunity with us to join our Peak Health team at WVU Medicine as a Benefit Configuration Analyst contributing to the foundation for an innovative new health plan. · This role will review implement and test new plan designs update existing be ...