Clinical Utilization Specialist

Job OverviewWe are seeking a skilled professional to join our clinical support team as a Clinical Support Specialist. As a vital member of our team, you will play a key role in customer satisfaction and be responsible for making every contact informative, productive and positive for our members and providers.You will have the opportunity to engage in live...

Job OpportunityAs a Clinical Appeals Nurse, you will be responsible for reviewing patients' medical charts to determine the appropriate course of action.Key Responsibilities:Review medical charts and lab results to assess hospital admission or observation requirements.Utilize strong clinical judgment to make informed decisions about patient care.Collaborate...

Job Title: Clinical Claims SpecialistThis is a fantastic opportunity for an experienced professional to thrive in a fast-paced environment and excel at managing medical claims.Main Responsibilities:Review and manage denied or aging claims by logging into client billing systems.Work claim queues to identify root causes of denials and submit necessary...

Home Healthcare AdministratorWe are seeking a skilled and experienced Home Healthcare Administrator to join our team. The successful candidate will be responsible for overseeing intake coordination, compliance, and clinical documentation.This is a critical role that requires strong clinical knowledge, excellent communication skills, and the ability to work...

Job Description:The Clinical Outreach role is responsible for designing and executing doctor outreach campaigns to activate clinical trial sites. This involves researching and filtering doctors using various tools, building targeting frameworks, and quality assurance of lists before launch.This high-trust, high-autonomy position requires a skilled...

Job OverviewWe are seeking a detail-oriented and reliable individual to support mental health professionals by creating and reviewing clinical notes with the assistance of ChatGPT. The role involves accurately entering finalized notes into multiple platforms while maintaining confidentiality and consistency.Key ResponsibilitiesDraft, review, and refine...

Our organization seeks a diligent Clinical Data Specialist to assume responsibility for submitting claims to insurance companies and ensuring timely payment.Key Responsibilities:Process data from medical coders, verify insurance coverage, and review denied claims.Provide administrative support, including data entry and verification, to patients with billing...

Medical Scribe Role OverviewThis is a dynamic position that involves closely collaborating with healthcare professionals to document clinical interactions in real-time, ensuring accurate and detailed patient records.

Utilization Review Specialist Role">We are seeking a skilled and experienced Utilization Review professional to join our team. As a Utilization Review Specialist, you will be responsible for assessing and interpreting customer needs, requirements, and medical records.Key Responsibilities:Review medical claims for medical necessityAssess and interpret...

Medical Coding SpecialistJob Summary:We are seeking a highly skilled Medical Coding Specialist to join our team in a primary care clinic setting.The ideal candidate will have extensive experience in medical coding and a strong understanding of ICD-10, CPT, and HCPCS guidelines. They will be responsible for accurately coding diagnoses, procedures, and...