Clinical Reviewer

We are seeking an experienced Clinical Quality Reviewer to support an annual Medical Record Review initiative. · The reviewer will play a key role in meeting state and federal reporting requirements, including submissions to the New York State Department of Health and CMS. · Main ...

Jet Health, Inc is seeking an experienced Home Health Clinical Reviewer to review clinical documentation. This role supports quality improvement efforts by verifying the accuracy of documentation submitted by field clinicians. · ...

+The Clinical Reviewer is responsible for evaluating conversations between patients and our AI system to determine whether the patient's reported condition meets specified clinical criteria. · +Evaluating conversations between patients and our AI system · ...

The Clinical Reviewer is responsible for reviewing medical records to identify Medicare Risk Adjusting diagnoses. · Strong clinical understanding and ability to interpret complex medical records · Knowledge of CMS Risk Adjustment models (e.g., HCC, ACO REACH) · ...

Jet Health, Inc is seeking an experienced Home Health Clinical Reviewer.Review OASIS assessments, · validate appropriate ICD-10 coding and ensure documentation supports medical necessity and skilled services. · Review OASIS assessments, · Validate appropriate ICD-10 coding and en ...

Acentra Health is seeking a dedicated and experienced Clinical Reviewer to join our growing and mission-driven team. · ...

The Post-Service Claims Nurse Reviewer is a pivotal role responsible for safeguarding the integrity of our claims process in a post-service, pre-payment environment. · ...

Job summary The Post-Service Claims Nurse Reviewer is a pivotal role responsible for safeguarding the integrity of our claims process in a post-service pre-payment environment In this position you will leverage your deep clinical expertise and business acumen to ensure all claims ...

Jet Health Inc seeks an experienced Home Health Clinical Reviewer to ensure compliance with Medicare guidelines and company policies reviewing clinical documentation. · ...

Clinical Reviewer opportunity who will be responsible for collecting analyzing and reporting clinical data elements on eligible cases for CMS TJC and multi hospital collaborations to improve Quality & Safety CQI. · Part time benefited position scheduled 40 hours bi weekly. · ...

Surgical Clinical Reviewer position available in Flushing NY for 3 months with possible extension. Bachelor's degree in healthcare required along with min 5 yrs clinical exp and previous experience w/ American College of Surgeons National Surgical Quality Program. · ...

We are seeking a Registered Nurse (RN) to perform medical reviews utilizing clinical information provided by physicians and providers. · ...

While working remotely as an independent contractor, you will apply your clinical expertise to provide objective recommendations on patient care based on standards of care. · ...

We are seeking Board-Certified Specialists to join our team as remote independent contractors. You will provide objective recommendations on patient care based on standards of care. · ...

We are seeking a Registered Nurse (RN) to perform medical reviews utilizing clinical information provided by physicians and providers. · Review complex medical claims, preauthorizations, and appeals. · ...

We are seeking Board-Certified Specialists to join our team as remote independent contractors. You will provide objective recommendations on patient care based on standards of care while working remotely. · ...

The Clinical Reviewer is responsible for reviewing medical records to identify Medicare Risk Adjusting diagnoses and creating clinical summaries. · Conduct detailed medical record reviews. · Create patient condition summaries. · ...

A Clinical Reviewer at Adventist HealthCare reviews clinical information to ensure accuracy and completeness. They oversee coding, care plan effectiveness, and patient care provision. · ...

While working remotely as an independent contractor, you will apply your clinical expertise to provide objective recommendations on patient care based on standards of care. · ...

+Job Summary · IHCS provides an Integrated Delivery System in the home setting, which includes DME, Respiratory, Home Health and Home Infusion services. · +ResponsibilitiesEnsure that home health care services are administered with quality, cost efficiency, and within compliance. ...