Physician Reviewer - Remote

JOB RESPONSIBILITIES · Medical Review - Performs medical review activities pertaining to delegated pediatric services including medical review of complex, controversial, or experimental medical services. · Quality - Assists Medical Director in improving quality and cost-effective ...

· Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. · Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of ...

Dane Street wants you to join our dynamic team of expert reviewers In this role you will have the opportunity to utilize your medical expertise to conduct thorough reviews of clinical cases telework opportunity allows you to customize your schedule as a 1099 independent contracto ...

· 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 ...

Telemedicine Cardiologist · We are a physician-led telemedicine group specializing in post-discharge care to help bridge the gap from hospital to home. Our hybrid care model combines telehealth and in-person care services, providing accessible and affordable care for seniors in p ...

The Physician Advisor will play a critical role in SmarterDx's expansion into the Utilization Management space. This role will work closely with Product and Data Science teams to apply real-world physician judgment to the development of clinical logic, · Review and refine AI-gene ...

We're on a mission to improve the healthcare experience for everyone—starting with the people who deliver it. We help physicians focus more on patient care and less on paperwork through smarter technology, purpose-built tools, and a team-based model of care. · Conducting Initial ...

· About MMRO · Managed Medical Review Organization (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 j ...

· Overview · The individual in this role will serve as the key point of contact for coding and documentation information for ProFee coding in the hospital and ASC setting, providing feedback, and charge capture resolution. Acts as a liaison between our Providers [Physician and/o ...

· Overview · The individual in this role will serve as the key point of contact for coding and documentation information for ProFee coding in the hospital and ASC setting, providing feedback, and charge capture resolution. Acts as a liaison between our Providers [Physician and/o ...

Position Summary: · The Staff Physician  provides direct patient care for WorldClinic by covering 24-hour on-call physician shifts and, during those on-call shifts, serves as the supervising/collaborating physician for JobSiteCare Advanced Practice Providers (NPs/PAs) as required ...

· Department Overview · The Utilization Management Department enacts the hospital UR Plan.  The department provides for the assessment of the medical necessity of admission and continued stay, appropriate bed status, denials management, and outlier review. The department provide ...

Who We're Looking For: · MyHealthTeam is looking for freelance medical reviewers who will assess and improve the medical accuracy of our content. Our medical reviewers ensure the accuracy of information like symptoms and treatments of a condition, medical terms, and statements ab ...

Position Summary: · The Collections and Payments Specialist is responsible for the performance of a broad range of collection activities related to obtaining payment for past due health insurance claims. The Collections and Payments Specialist will maintain expertise in organizat ...

We are seeking a Clinical Sales Representative to join our dynamic and collaborative team. The successful candidate will report to the Clinical Sales Manager and be responsible for delivering an excellent customer experience for all Galaxy customers within their territory. · The ...

· Description · Position at Nuvance Health · FULL TIME DAY SHIFTS- VARIABLE HOURS / WEEKEND ROTATIONS REQUIRED · Hybrid/Remote · Summary: · The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within the first 12-24 hours a ...

The Billing Specialist (Biller) is responsible for the performance of a broad range of billing activities related to processing of claims for physician and practice-related ancillary services. The Billing Specialist will maintain expertise in claims submission, accounts receivabl ...

· Psychiatrist - Collaborating Physician · Location: Texas · Employment Type: Part-Time · Reports To: Market President · About Peregrine Health · Peregrine Health partners with Federally Qualified Health Centers (FQHCs)  to design and operate behavioral health service lines in u ...

· Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans ...

· It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. · Job Summary: · The Prior Authorization Clinician is responsibl ...

The Physician Operations Coordinator provides scheduling, clerical, and administrative support for Leading Edge Emergency Physicians (LEEP) within Emerus. This role serves as a key liaison between physicians and internal operational teams to ensure efficient day-to-day operations ...