Clinical Reviewer

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

Acentra Health is seeking a dedicated and experienced Clinical Reviewer to join our growing and mission-driven team. · This is a remote work position; however, candidates must reside in the state of California and hold an active California LMFT or LCSW license to be considered.In ...

+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 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. · ...

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.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 ...

Clinical reviewer oportunidad de trabajar en la recopilación, análisis y reporte de datos clínicos para mejorar calidad y seguridad. · ...

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. · ...

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) · ...

We are seeking an experienced Clinical Quality Reviewer to support an annual Medical Record Review initiative. · Maintain working knowledge of medical record review processes and EMR systemsStay current on HEDIS, QARR,Distribute medical record requests and coordinate appointments ...

We are looking for a · Clinical Reviewer (MD, DO, MBBS, or equivalent) - Remote · with clinical imaging experience contribute to advanced AI model training by creating diagnostic questions, · reviewing AI outputs and providing structured feedback.Radiology experience and clinica ...

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. · ...

Adventist Healthcare Home Health seeks to hire an experienced Clinical Reviewer (RN/PT/OT) who will embrace our mission to extend God's care through the ministry of physical, mental and spiritual healing. · We do this by offering:Work life balance through nonrotating shifts · Rec ...

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 a Clinical Reviewer to join our growing team. The Clinical · Reviewer utilizes clinical expertise during beneficiary interaction in conjunction with contract requirements, · critical thinking and utilize decision-making skills to assist with communicating medical ...

We are seeking a Clinical Reviewer to join our growing team. · The Clinical Reviewer utilizes clinical expertise during beneficiary interaction in conjunction with contract requirements, · critical thinking and utilize decision-making skills to assist with communicating medical a ...

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. · ...