Clinical Review Nurse Specialist

Job DescriptionClinical Appeals Nurses review patients' medical charts and determine if they require admission, observation or no hospital care at all.This role involves reviewing medical records/lab work ups to ensure accurate diagnoses and effective treatment plans.The Clinical Appeals Nurse will work closely with healthcare professionals to resolve...

The Remote Clinical Assistant role offers an opportunity to work in a dynamic and supportive environment, providing direct support to the Director of Nursing in overseeing clinical operations for home care services.This position is responsible for assisting with documentation, compliance, scheduling, and care coordination to ensure the program runs...

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...

We are seeking researchers to evaluate manuscripts for journals and publishers. This is a unique opportunity to utilize your advanced degree in clinical microbiology to contribute to the scientific community.RequirementsA PhD or MD in clinical microbiology, or equivalent qualification.Two publications in the last two years in clinical microbiology.Expertise...

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...

Job OverviewThis is a role that involves research and analysis of medical coding and billing documents to identify claim denial or covered criteria for an automated claims editing solution.The clinical content could include additions, deletions, or updates to diagnosis codes, procedure codes, age minimums & maximums, quantity limitations, place of service...

Clinical Nurse Case Manager RoleEffective patient care and optimal healthcare outcomes are crucial in today’s dynamic medical landscape. Clinical Nurse Case Managers play a vital role in ensuring patients receive high-quality, cost-effective care.Key Responsibilities:Coordinate patient care to achieve the best possible resultsDevelop and implement...

Job OverviewWe are seeking a skilled professional to oversee the intake coordination process for new patients in a fast-paced home healthcare environment.Key Responsibilities:Coordinate the intake process, ensuring compliance with regulations and maintaining accurate documentation.Collaborate with physicians and nurses to review and edit clinical notes, as...

Healthcare Data Analyst RoleThis position plays a pivotal role in supporting clinical and coding operations through precise data analysis.We are seeking an experienced Healthcare Data Analyst to join our team. The successful candidate will have a strong background in U.S. healthcare analytics, medical coding, or risk adjustment, with a minimum of 2 years'...

Clinical Data SpecialistAs a Clinical Data Specialist, you will play a vital role in ensuring the accuracy and integrity of patient data during the electronic health record (EHR) migration process. You will be responsible for reviewing, comparing, and validating patient data from the source system to the new platform. This requires a high level of attention...