Overview As a Medical Reviewer, you will be auditing medical records to evaluate the accuracy of medical coding and health plan policies for our Fraud, Waste & Abuse clients. Responsibilities Conducts audit of medical records and
Imagine360 is seeking a Benefit Review RN to join the team! The Benefit Review Nurse RN is responsible for providing benefit review/ utilization review and processing the independent physician review request for individuals under the group health plans administered by Imagine360
Posting number: 2026-07070 Department: Health Care Authority Division: DLS Job classification: WMS BAND 3 Posting type: Open & Promotional Categories: Administration, Legal, Executive Management, Miscellaneous, Health Care Support, Program Management, Insurance Summary Chief Review Judge (WMS3/DLS) 71028362
Company Description WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries, including Banking and Financial Services, Healthcare, Insurance, Shipping and Logistics, and Travel
Job Description Highlights of the skills and qualifications needed for the Medical Review Nurse: Registered Nurse with a compact/multi-state license Must be willing to work a schedule within the Central Time Zone, Monday - Friday Have at
JOB DESCRIPTION Highlights of requirements: Fully remote position to conduct Prior Authorization reviews for services. Open to candidates across the country, but you MUST have an active RN license in good standing in the state Illinois. Priority
Location:For Those Who Work At Home, Ohio Job Summary Credit Risk Review (CRR) is considered part of the second line of defense. CRR is accountable to the organization’s Chief Risk Officer and KeyCorp Board of Directors and
Vālenz® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to
AIP Publishing is a leading publisher of the physical sciences. Working with us means being part of a mission: to accelerate scientific discovery while reimagining the future of scholarly publishing. AIP Publishing helps brilliant work make
About This Position ABOUT AUSTIN WATER: For over 100 years, Austin Water has been committed to providing safe, reliable, high-quality, and affordable water services to our customers. Today, we serve over 1,000,000 people in the Austin
About Our Job With competitive pay, great benefits, and endless opportunities, working for the City and County of Denver (CCD) means seeing yourself working with purpose — for you, and those who benefit from your passion,
Mary Free Bed Summary We have the great privilege of helping patients and families re-build their lives. It’s extraordinarily meaningful work and the reason we greet the day with optimism and anticipation. When patients “Ask for
Job Type Full-time Description Gateway Rehab Center (GRC) is hiring a full-time Utilization Review Liaison! In this important administrative and clinical support role, you will help ensure patients receive the appropriate level of care by coordinating authorizations,
The Diagnostic Related Groups (DRG) Clinical Supervisor is responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to determine correct DRG/coding that is clinically supported as defined by review methodologies specific to the contract
The Diagnostic Related Groups (DRG) Clinical Supervisor is responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to determine correct DRG/coding that is clinically supported as defined by review methodologies specific to the contract
As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we
WPP is the trusted growth partner for the world’s leading brands. We unite cutting-edge media intelligence and data solutions, world-class creativity, next-generation production, transformative enterprise solutions and expert strategic counsel in a single company – powered
Status: Regular, Full-Time Work Location: Hybrid, Vancouver, BC (a minimum of 2 days in office) Who we are The British Columbia College of Nurses & Midwives (“BCCNM”) is the college empowered under the Health Professions and
Do you want your voice heard and your actions to count? Discover your opportunity with Mitsubishi UFJ Financial Group (MUFG), one of the world’s leading financial groups. Across the globe, we’re 150,000 colleagues, striving to make
Description This position can be located near a Huntington Bank Corporate office building Summary: The Business Analyst - Sr leads assigned projects and/or provides advanced specialized consultative support to other team members for assigned business process