, ensuring consistency, transparency and optimization, including for milestone reviews; meeting management and team management...

Responsibilities: Conduct utilization reviews for appropriate care level/coverage Coordinate discharge planning and post-acute care...

concurrent, prospective, and retrospective reviews of patient cases Collaborate with physicians, case managers, and healthcare...

agreements. Reviews loan (or collateral) documents, handles file processing and works with external/internal clients and contacts...

Responsibilities: Conduct utilization reviews for appropriate care level/coverage Coordinate discharge planning and post-acute care...

QA reviews for multiple team members, including bills processed by the supervisor Support the supervisor with special...

vendors and manage issues/field questions to maintain the integrity of the appraisal assignment. Reviews the quality...

Utilization Review Coordinator, you will: Complete initial precertification and concurrent reviews for patients in the inpatient...

Utilization Review Coordinator, you will: Complete initial precertification and concurrent reviews for patients in the inpatient...

status Ensures processes are in place for proactive reviews of surgical and other procedures to confirm accurate...

-hour observations reviews for all patients c) Support Utilization Review Coordinator team members on cases escalated...

Audit reviews. Identify overcharges, undercharges and unbundled items. Identify unbundled items on the itemized bill...

prior authorization, prospective, concurrent, and retrospective reviews for medical necessity and appropriateness... authorization reviews using InterQual or MCG. Strong written communication skills in a fast-paced setting. Proficient in Microsoft...

contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR... organizations, external reviews, and other payers. Communicate with physicians to schedule peer to peer reviews. Accurately report...

, and outflows Maintain the MRB (Material Review Board) files and conduct weekly reviews with management Lead activities...

an opinion on portfolio quality Participating in or leading Targeted Reviews to assess key risks in a given portfolio...

prior authorization, prospective, concurrent, and retrospective reviews for medical necessity and appropriateness... authorization reviews using InterQual or MCG. Strong written communication skills in a fast-paced setting. Proficient in Microsoft...

to facilitate the effective management of contract attorneys including timesheet reconciliations, monitoring the pace of reviews...

Development and Reviews Consulting BU Operations The Organization We help society’s foundational healthcare institutions...

and services are medically appropriate Performs prior authorization reviews related to mental health and substance abuse...