Utilization Reviewer Salary at Cipher Billing BETA

Responsibilities Come and join the RMC Family! We have been in the community since 1935. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and talents are invaluable to us and our mission to serve others. Our facility can provide a place for you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare. Riverside Medical Clinic is the best place to work, practice medicine, and receive care. SUMMARY: Responsible for the processes of evaluating the necessity, appropriateness, and efficiency of outpatient/ambulatory services per health plan and regulatory standards. Assists the Manager of Medical Management and/or the Regional Director of Quality Risk & Utilization Management in preparing required documentation for Health Plan audits and appeals. This role entails overseeing

Overview: UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among Americas Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange Countys only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles Co

Current Emanate Health Employees - Please log into your Workday account to apply Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as individuals. On Glassdoor's list of "Best Places to Work" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country. Job Summary The Utilization Review Nurse will evaluate medical records to determine medical necessity by applying clinical acumen and the appropriate application of policies and guidelines to urgent and standard reviews. You will document decisions using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and level of care reviews for requested servi

Report to Lead for daily picking/checking assignment, for either Forward Picking Line FPL or Truck orders. Responsible for stocking up on material needed to pick orders throughout the day (boxes, labels, packing slip, pallets, etc.). Utilize RF uni Picker, Checker, Operations, Manufacturing, Warehouse

The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay; supporting the goals of the Case Management department, and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Identifies the necessity of the review process and communicates any specific issues of concern to the appropriate claims staff/customer. Collects data and analyzes information to make decisions regarding certification or denial of treatment. Documenting all work in the appropriate manner. Requires regular and consistent attendance. Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP). Additional duties as required. KNOWLEDGE & SKILLS: Must have a thorough knowledge of both CPT and ICD coding. Effective multi-tasking skills

Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Los Angeles, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel Were seeking talented healthcare professionals whose adventure game is as strong as their clinical game. Those that want flexibility and high pay, we have the positions for you! Some of the industry-leading benefits enjoyed by Medical Solutions travel nurses and travel allied healthcare professionals include: Day One Medical, Dental, and Vision with low premiums Day One 401(k) with Company Contribution Personalized Compensation Packages Loyalty Bonus Program and Referral Bonus Paid, Private, Fully Furnished, Pet-Friendly Housing Dedicated Recruiter and 24/7 Customer Care Line Per Diem Allowance and Paid Travel Licensure and Certification Reimbursement Free Liability Coverage Voluntary Benefits: Criti

Current Emanate Health Employees - Please log into your Workday account to apply Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as individuals. On Glassdoor's list of "Best Places to Work" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country. Job Summary The Utilization Review Nurse will evaluate medical records to determine medical necessity by applying clinical acumen and the appropriate application of policies and guidelines to urgent and standard reviews. You will document decisions using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and level of care reviews for requested servi

With Staff Management | SMX, you'll get a weekly paycheck, learn new skills, meet new people, and work with a great management team in a clean and safe environment. Apply Today to join our Team! Staff Management/SMX is seeking individuals for the flight checker position. Shift Times: 5 AM-1:30 PM 1 PM-9 PM 9 PM-5 AM . Perks & Benefits: Climate Controlled Environment, Paid Training, Weekly paychecks, Direct Deposit or Cash Card pay options, Medical / Dental Insurance, Paid Sick Leave, Paid Time Off. Shifts: All Shifts, 1st Shift, 3rd Shift. Employment Types: Full Time, Long Term. Pay Rate: $18.72 - $19.22 / hour Duties: FUNCTIONS and RESPONSIBILITIES: Move completed carts/carriers from food or equipment to final cooler prior to KRT once packing and department QA is complete Coordinates retrieval of missing/callback items identified by the flight checker from EQ and Food supervisor or team leader Performs dairy and ice packing as needed Other duties as assigned QUALITIES and SKILL REQUIR