Utilization Review Specialist

The role of a Utilization Review Specialist involves assessing and interpreting customer needs, requirements, and medical records. This position requires a strong understanding of medical necessity and the ability to review medical claims effectively.Key responsibilities include:Reviewing medical claims for medical necessityAssessing customer needs and...

Content Review Specialist Role OverviewWe are seeking a skilled Content Review Specialist to ensure the high quality of edited manuscripts.Main ResponsibilitiesConduct thorough manuscript reviews to meet international publication standardsProvide timely and constructive feedback to editors to improve manuscript qualityManage deadlines and maintain...

Job DescriptionWe are seeking a highly skilled Immunology Peer Review Specialist to join our team of experts. As an Immunology Peer Review Specialist, you will be responsible for reviewing and evaluating manuscripts in the field of immunology.Required Skills and QualificationsYou should have a Doctorate (PhD/MD) or equivalent advanced degree in the subject...

Position Title:Mgr Asst Utilization Mgmt (PHL)Shift:Job Description:Responsible for providing technical direction, guidance and resources to UM staff on a day-to-day basis. Primary duties may include but are not limited to: Manages creation, launching and coordination and development of UM quality initiatives. Provides inputs to policies and processes...

Medical Review SpecialistWe are seeking a highly skilled and organized Medical Review Specialist to join our team. As a Medical Review Specialist, you will play a vital role in preparing case files and Disability Benefits Questionnaires (DBQs) assigned in the client portal.Key Responsibilities:Prepares case files and DBQs assigned in the client...

Job OverviewThis position involves conducting comprehensive reviews and case consultations to support client care. The ideal candidate will be a licensed clinical or medical professional with expertise in behavioral health documentation and insurance requirements.Key Responsibilities:Conduct thorough peer reviews and case consultations to secure continued...

Job TitleWe are seeking highly motivated individuals to join our team as Content Review Assistants. As a key member of our content review team, you will play a vital role in protecting creators' rights and ensuring the integrity of our platform.In this role, you will be responsible for reviewing potential copyright infringements, taking appropriate actions,...

Job OverviewWe are seeking highly qualified experts to perform in-depth reviews for esteemed journals and publishers in the field of Clinical Oncology.This role is perfect for specialists who can contribute to advancing knowledge in their respective fields.Key ResponsibilitiesEvaluate study design, methodology, and literature review.Analyze results and...

Freelance Peer Reviewer OpportunityWe are seeking researchers with advanced degrees to perform peer reviews for journals and publishers.This is a contract-based opportunity that requires a thorough understanding of research methodologies and ethical principles within the relevant discipline.The ideal candidate will have:A Doctorate (PhD/MD) or equivalent...

Job Title: Claims Review SpecialistAbout the RoleWe are seeking a highly detail-oriented and analytical individual to fill our Claims Review Specialist position.Main Responsibilities:Evaluate customer claims submitted through various channels to determine validity and eligibility based on established policies and procedures.Investigate claims, gather...