Assignment Review Specialist

Utilization Review Specialist | Virtual Process.We are seeking a highly skilled Utilization Review Specialist to join our team. As a Utilization Review Specialist, you will be responsible for assessing and interpreting customer needs, requirements and medical records. You will also review medical claims for medical necessity.To succeed in this role, you must...

We are seeking a skilled Medical File Reviewer to join our team. The ideal candidate will have excellent communication skills and be able to work independently with minimal supervision.Job DescriptionThe Medical File Reviewer will be responsible for preparing case files and Disability Benefits Questionnaires (DBQs) assigned in the client portal. This...

As a Peer Review Specialist, you will be responsible for conducting thorough peer reviews and case consultations to support continued authorization.This role requires excellent communication skills to effectively interface with insurance payers.Main ResponsibilitiesConduct comprehensive peer reviews and case consultations to secure continued stay...

Expert Reviewer OpportunityJob SummarySeeking experienced researchers to conduct thorough peer reviews for academic journals and publishers.Key Responsibilities:Evaluate Manuscript Novelty: Assess whether the manuscript presents original research and contributes significantly to the field of study.Study Design and Methodology Evaluation: Determine if the...

Job OpportunityWe are seeking a skilled Clinical Review Nurse to conduct clinical review of cases not meeting criteria. The successful candidate will perform clinical intake and adjudicate requests as needed, while escalating to Medical Directors when required.Key Responsibilities:\

Medical Coding SpecialistWe are seeking a detail-oriented and experienced Medical Coding Specialist to review clinical documentation, accurately assign codes, and ensure clean claim submission and compliance with payer and regulatory guidelines.The ideal candidate will have strong knowledge of ICD-10-CM and CPT coding systems, as well as familiarity with...

Job OverviewAs a licensed USRN, this role involves conducting non-clinical research to support case determinations and team reviews. This is an exciting opportunity to join a dynamic team and contribute to the development of healthcare services.Key Skills and QualificationsA strong foundation in nursing with at least 1 year of hospital and clinical...

Financial Specialist RoleAs a Financial Specialist, you will be responsible for reviewing financial documents, creating general ledger transactions, and sending invoices on a daily basis.Key ResponsibilitiesFinancial Document Review: Carefully review financial documentation to ensure accuracy and compliance.Transaction Creation: Prepare and create general...

Who We Are:At Tribe Wellness Sales, Inc., we teach our Protocol Review Specialists how to ethically sell health and wellness products to help our customers live a healthy and fulfilling life.We are currently seeking independent Protocol Review Specialists to attend our Protocol Review Appointments with the goal of generating sales of health and wellness...

Appointment Specialist RoleAs an Appointment Specialist, you will play a critical role in ensuring the accuracy and compliance of scheduled appointments to prevent issues and conflicts. This position requires meticulous oversight of appointment codes, schedule adjustments, and the maintenance of critical scheduling documents.You will coordinate and verify...