Medical Necessity Evaluator

Medical Billing CareerThis role is an excellent opportunity for a detail-oriented and organized professional to assist in meeting responsibilities with accuracy and timeliness.Duties and ResponsibilitiesVerify the medical necessity of appeals submitted by providers.Fax appeals to relevant parties in a timely manner.Set reminders to follow up on appeal...

Job Description:">The Peer Review Specialist plays a vital role in ensuring the highest quality of care for our clients. This individual will conduct thorough reviews of client charts, including progress notes, psychiatric evaluations, and medical histories, to determine medical necessity for continued care.">Key Responsibilities:">">Conduct peer reviews and...

Medical Reviewer - Wound Care SpecialistAt Limitlessli, we specialize in recruiting high-caliber remote staff for dynamic healthcare facilities. We connect clients with highly qualified professionals, offering tailored services to meet their unique business needs.The Opportunity:We seek a skilled Medical Reviewer focused on wound care, specializing in...

Medical Review SpecialistOur organization is seeking a highly skilled Medical Review Specialist to assess and interpret customer needs, requirements and medical records.About the Role:Review medical claims for medical necessity by assessing customer needs, requirements and medical records.Ensure compliance with relevant laws, regulations and policies.Key...

Job OverviewWe are currently seeking a Medical Billing Specialist to support our team in meeting their responsibilities in a timely and accurate manner.ResponsibilitiesReview medical necessity appealsFacilitate the appeal process by faxing relevant information to the appropriate partiesSet reminders to follow up on appeal status and ensure timely...

Job OpportunityWe are seeking a Medical Documentation Specialist to provide accurate and efficient documentation of patient encounters.The ideal candidate will have proven experience in medical scribing, healthcare documentation, or related fields.Key Responsibilities:Real-time Electronic Health Record (EHR) Documentation: Accurately document patient...

**A/R Collections Expert – Medical Billing (Speech, Physical, and Occupational Therapy)Location: Remote – PhilippinesEmployment Type: Full-Time (Mid Shift)**Role SummaryThe A/R Collections Expert will be responsible for ensuring timely recovery of outstanding claims in U.S. medical billing, with a focus on Speech, Occupational, and Physical Therapy...

Job Title: Clinical Utilization Review SpecialistJob Description:We are seeking a skilled Clinical Utilization Review Specialist to assess and interpret customer needs, requirements, and medical records. The ideal candidate will review medical claims for medical necessity, ensuring that services meet the highest standards of quality and care.Required Skills...

Healthcare Utilization SpecialistWe are seeking a skilled healthcare utilization specialist to enhance patient outcomes.Key Responsibilities:Assess and interpret customer needs, medical records, and requirements.Review medical claims for medical necessity and accuracy.Collaborate with healthcare professionals to ensure optimal treatment...

Philippine Registered Nurse should have:Minimum of 1 year of direct bedside care experience in an acute care hospital setting (excluding clinics), with a strong preference for backgrounds in Emergency Room (ER), Intensive Care Unit (ICU), Medical-Surgical, Neonatal Intensive Care Unit (NICU), or Operating Room (OR) environmentsAt least 1 year of hands-on...