Plautdietsch Medical Interpreter Specialist

Medical Coding SpecialistThe Medical Coding Specialist will be responsible for conducting thorough research and analysis of Medicare, Medicaid, and other medical coding documents to identify claim denial or covered criteria. This role involves providing written and oral presentations to clinical colleagues to obtain consensus on proposed denial criteria.This...

As a seasoned professional in medical necessity review, you will be responsible for assessing and interpreting customer needs, requirements, and medical records.Key Responsibilities:Review medical claims to ensure they meet established standardsAnalyze customer needs and requirements to provide informed recommendationsWork independently with minimal...

Job Title: Healthcare Utilization SpecialistThe Role:As a Healthcare Utilization Specialist, you will be responsible for assessing and interpreting customer needs, requirements, and medical records.Responsibilities:Review medical claims for medical necessityAssess and interpret customer needs, requirements, and medical recordsQualifications:Active PHRN and...

We are seeking a skilled Medical Claims Specialist to manage accounts receivables, coordinate with insurance companies and healthcare providers, handle denied claims, and ensure timely reimbursement of medical expenses.Key Responsibilities:Manage accounts receivables and maintain accurate recordsCoordinate claim submissions and follow-ups with healthcare...

Medical Coding SpecialistThe professional in this role functions under the direction of a coding director and is responsible for assigning medical codes by abstracting and reviewing medical documentation according to established coding guidelines, payer guidance, and government regulations. This specialist must possess a high level of integrity, requiring a...

We are seeking a Medical Claims Specialist to join our team. As a key member of our organization, you will be responsible for maximizing insurance reimbursement, identifying root causes for claim denial, and interacting with US-based insurance carriers.About the RoleMaximize insurance reimbursement for healthcare practice owners by ensuring accurate and...

Prior Authorization ProfessionalOur organization seeks a seasoned professional to assume the role of Prior Authorization Specialist. As a key member of our healthcare division, you will be responsible for obtaining all types of prior authorizations for medical services, procedures, and medications.Key Responsibilities:Review and process prior authorization...

Job Opportunity: Medical Compliance SpecialistWe are seeking a detail-oriented and organized individual to assist our Compliance team in maintaining the most current laws, procedures, and guidelines for all assigned states. This role requires strong research skills, excellent verbal and written communication, and the ability to plan and prioritize tasks to...

Job Title: Healthcare SpecialistA clinical review nurse is responsible for conducting thorough assessments of medical cases to ensure they meet the necessary criteria.This involves performing clinical intake and adjudicating (closing) cases, as well as requesting additional information or escalating to medical directors as needed.

Job Title: Medical Coding SpecialistWe are seeking a skilled Certified Medical Biller and Coder to excel in accurate and timely submission of medical claims, optimizing revenue cycles while maintaining compliance with regulatory standards.Key Responsibilities:Analyze and abstract medical information from patient records for physician/NP visits and home...