Utilization Management Physician Reviewer - Remote

The physician reviewer performs medical review activities pertaining to delegated pediatric services including medical review of complex controversial or experimental medical services. · ...

We're hiring a Physician Reviewer to join our Utilization Management team. Determine the medical appropriateness of inpatient, outpatient, and pharmacy services by reviewing clinical information and applying evidence-based guidelines. · You are also eligible for employee benefits ...

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 ...

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 ...

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 ...

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 ...

· Supervising Physician – Urgent Care (Georgia) · Position Title: Supervising Physician – UrgenCare · Location: Georgia (Remote supervision with availability during clinic hours) · Specialty Preferred: Urgent Care, Emergency Medicine, Family Practice, or Internal Medicine · Posi ...

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 ...

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

The Clinical Documentation Integrity Specialist will review inpatient medical records for completeness and accuracy. ...

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. · ...

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 ...

The Lead 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 receivable management, interpretation of related practice documentation, · and other relevant tasks to support a best-in-class patient care platform. · ...

Part-Time Medical Director Opportunity – Flexible, Remote, and Lucrative Location: Virginia | Specialty: Family Medicine or Internal Medicine SynergenX / Low T Center is seeking a Board-Certified Family Medicine or Internal Medicine Physician in Virginia to serve as a supervising ...

Peregrine Health partners with Federally Qualified Health Centers (FQHCs) to design and operate behavioral health service lines in underserved communities. We're building accessible, high-quality mental health care where it's needed most. · ...

We are building a world-class auto immunology pipeline with our allogeneic CAR-T platform. · Serve as global Clinical Lead (Lead Physician) for neuro-immune and other auto-immune assets. · ...

We are seeking a Clinical Documentation Quality Improvement (CDQI) Specialist to elevate the impact of our medical record documentation. The ideal candidate will conduct daily evaluations and engage in direct communication with providers to enhance documentation clarity, complete ...

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. ...

We seek to create an environment that cultivates your professional development and personal growth as we believe your success is our success. · Perform Peer-to-Peer case discussions with payer medical directors · Utilize clinical expertise to identify the salient points within a ...

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 ...