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CLINICAL REVIEWER (MEDICAL CODING ACADEMY - CPC) - SAN JUAN, PR

Clinical Case Reviews -75%Perform clinical review of professional (or facility) claims vs. medical records to determine if the claim is supported or unsupported.Maintain standards for productivity and accuracy. Standards are defin...

CompanyOptum
AddressSan Juan, PR
CategoryHealthcare
Job typeFull-time
Date Posted just now See detail

Clinical Reviewer (Medical Coding Academy - CPC) - San Juan, PR New

Optum

San Juan, PR

Clinical Case Reviews -75%Perform clinical review of professional (or facility) claims vs. medical records to determine if the claim is supported or unsupported.Maintain standards for productivity and accuracy. Standards are defin...

RN Pre-Service Clinical Review

Kaiser Permanente

Renton, WA

Conducts Clinical Review of coverage request based on the application of medical necessity criteria, understanding of individual coverage contracts and ability to meet Kaiser Foundation Health Plan of Washington, coding rules and...

Clinical Studies Report Reviewer

Sqa Services

Remote - Oregon, United States

Study Details Demographics Test Product Accuracy Study Plan Results Source verify data with source documents from CRO and master study file, protocol, and product information Any reporting on Adverse Events Deviations are clearly...

Clinical Review Nurse I - Medicare Part B (US)

Elevance Health

Atlanta, GA

Assesses the necessity and reasonableness of the items supplied in a valid claim through the use of medical policy and other materials. . Requires AS in nursing and minimum of 1 year of clinical experience; or any combination of...

Registered Nurse- Risk Manager Clinical Reviewer

Department Of Veterans Affairs

Martinsburg, WV

Competitive

Demonstrates knowledge in the interpretation and application of accrediting body standards and other agency requirements. Assists with monitoring of various aspects of care provided to Veterans and the analysis and interpretation...

Registered Nurse Clinical Denials & Appeals Reviewer

Administrative Regional Training Cntr

Buffalo, NY

$36.19 - $54.29 an hour

Registered Nurse with a current New York State license Bachelor of Science Nursing degree Holds, or will obtain within one (1) year of hire, one of the following (or similar) credentials: Certified Documentation Specialist, Certif...

Clinical Review Nurse - Prior Authorization

Bcforward

Indianapolis, IN

Clinical Review Nurse - Prior AuthorizationBC Forward is looking for Clinical Review Nurse - Prior Authorization (Remote Work) Position Title: Clinical Review Nurse - Prior Authorization (Remote Work) Locations: Remote IN (Local t...

Clinical Nurse Review - II

Progressive Technology Solutions

Owings Mills, MD

$35 - $39 an hour

8 hour shift. Owings Mills, MD 21117: Relocate before starting work (Required)....