Healthcare Industry Reviewer
24 hours ago
Our organization is seeking a highly skilled Utilization Review Specialist to join our team. The successful candidate will be responsible for assessing and interpreting customer needs, requirements, and medical records.
The specialist will review medical claims for medical necessity, ensuring compliance with relevant laws and regulations.
Key responsibilities include:
- Active PHRN and USRN Mainland License.
- 1 year bedside experience, preferably with UR/UM experience but not required.
As a Utilization Review Specialist, you will possess excellent critical thinking and problem-solving skills, as well as strong communication and interpersonal abilities.
Ability to work independently and as part of a team.
Specialized knowledge of healthcare industry and insurance guidelines.
Achieve high level of productivity while maintaining accuracy and quality in results.
This role requires dedication and perseverance in performing complex tasks.
Accurate interpretation of medical data and application of medical principles.
Ensuring complete understanding of the impact of treatments on patient outcomes.
Continuous improvement of processes and procedures to meet business objectives.
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Healthcare Industry Account Manager
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Healthcare Utilization Specialist
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Healthcare Peer Review Specialist
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Healthcare Professional Opportunity
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Healthcare Support Specialist
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Medical Industry Operations Director
1 day ago
Cainta, Calabarzon, Philippines beBeeLeadership Full time $90,000 - $120,000Healthcare Leadership OpportunityLead a team of professionals in the healthcare industry, ensuring high-quality medical products are delivered with logistical excellence.Oversee daily operations to drive business growth and client satisfaction.The ideal candidate will have:3-5 years of leadership experience in a similar setup.Strong knowledge of U.S....
