Human Resources SME Content Writer and/or Reviewer - Chicago - BenchPrep

Dane Street busca un médico interno para realizar exámenes médicos independientes. El trabajador debe tener experiencia en medicina interna y estar credenciado. · ...

We are looking for cannabis connoisseurs who think they have what it takes to join our ranks as a reviewer of Illinois marijuana dispensary products. · Investigate, research, and report on the various characteristics of cannabis products. · Write amazing reviews and take excelle ...

This position is responsible for conducting clinical reviews and treatment plans at Department of Human Services (DHS)/Division of Behavioral Health and Recovery (DBHR) hospitals in Illinois. · ...

This role provides medical necessity reviews for pre?service clinical requests on a remote, weekend?only schedule. The position requires an initial 4?week training period, followed by ongoing weekend coverage for at least two weekend days per month. · Conduct pre?service medical ...

This role provides medical necessity reviews for pre-service clinical requests on a remote, · weekend-only schedule. Physicians work 8-hour shifts on Saturdays and/or Sundays, · with a productivity expectation of 32 cases per day.Conduct pre-service medical necessity reviews base ...

Job summary · Evaluate clinical service requests from members and providers using clinical judgment and organizational criteria. · ...

Dental Dreams / KOS Services LLC busca un Claim Reviewer motivado para unirse a su equipo. La posición revisa reclamos no pagados recopilando información del estado de los reclamos para garantizar pagos oportunos. · ...

This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity. · ...

This position is responsible for pre-authorization reviews in accordance with medical contract regulations. · ...

This position performs medical review of claims suspended for medical necessity using medically accepted criteria. · Candidates must reside in TX or IL · ...

Evaluate the core functionality of various applications (mobile and/or web), ensuring that all features work as intended and meet specified requirements. · , · , · , · , ...

This position is responsible for ensuring compliance of the Utilization Management (UM) and Quality Review (QR) functions performed by the Medical Groups/IPAs participating in the networks of client's HMOs. · 3 years clinical experience with 2 years' experience in utilization rev ...

We are looking for a highly motivated and detail-oriented individual to join our QA team as an In-App Experience Reviewer. You'll be responsible for meticulously evaluating user journeys within various mobile applications, testing functionality, and providing crucial feedback to ...

+ Utilization Review Specialists bridge between a Utilization Review Nurse and Pre-Clinical Coordinator + Facilitate and schedule appointments as needed + Maintain appropriate electronic and paper files + Interface with inter-disciplinary providers + Basic invoicing at completion ...

Provides support for clinical member services review assessment processes, verifying that services are medically necessary and align with established clinical guidelines. · ...

Coordinates medical records reviews. Participates in Case Management and Treatment Team meetings. Serves as educator to departments. · ...

This role supports the end to end appeals process to ensure timely accurate and compliant resolution of member and provider appeals. You will collaborate across multiple operational teams uphold regulatory and accreditation standards and contribute to continuous improvement initi ...

This position is responsible for ensuring compliance of the Utilization Management (UM) and Quality Review (QR) functions performed by the Medical Groups/IPAs participating in the networks of client's HMOs. · ...

+The Medical Director is responsible for the overall quality, effectiveness and coordination of medical review services. · +Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies. · Renderecoverage determinations. · ...

This position is responsible for pre-authorization reviews in accordance with the medical contract and regulations. · ...

Review and analyze referrals and supporting documentation to determine medical necessity of medical and dental services. Compose approval and denial letters as deemed appropriate. · ...