Utilization Review Specialist

Job Title: Utilization Review SpecialistWe are seeking a skilled professional to assess and interpret customer needs, requirements, and medical records.Key Responsibilities:Assess and interpret customer needs, requirements, and medical records.Review medical claims for medical necessity, ensuring alignment with industry standards.Requirements include an...

Utilization Review professionals are in high demand, and Nezda Technologies Inc. is looking for skilled individuals to join their virtual team.Responsibilities:Assess customer needs and requirementsInterpret medical recordsReview medical claims for medical necessityRequirements:Active PHRN and USRN Mainland LicenseAt least 1 year of bedside experience,...

Utilization Management SpecialistWe are seeking a skilled Utilization Management Specialist to join our team.Job Description:Our ideal candidate will assess and interpret customer needs, requirements and medical records, reviewing medical claims for medical necessity.Key Responsibilities:Assess and interpret customer needs, requirements and medical...

Job Title: Quality Review SpecialistAt our company, we're seeking a skilled Quality Review Specialist to join our team. As a key member of our quality control process, you will be responsible for ensuring that our customers' requests meet our high standards.Key Responsibilities:Review customer requests to ensure they align with our quality control...

Job Title: Virtual Utilization ManagerWe are seeking a skilled Virtual Utilization Manager to join our team. The ideal candidate will possess strong analytical skills, excellent communication abilities, and experience in healthcare.The Virtual Utilization Manager will be responsible for assessing and interpreting customer needs, requirements, and medical...

We're seeking talented individuals to join our team as Content Review Specialists. As a Content Review Specialist, you will play a crucial role in protecting creators' rights by identifying and addressing copyright infringements.Key ResponsibilitiesConduct thorough reviews of potential copyright infringement casesProactively identify undetected infringement...

Peer Reviewer OpportunityWe are currently looking for researchers, retired researchers, and former researchers who can perform peer reviews for journals and publishers. You should be able to disclose your full name and affiliations with the publishers.Key ResponsibilitiesAssess novelty: assess whether the manuscript is original and adds new knowledge or...

Improve patient care by working as a Utilization Management specialist in a virtual environment.Key responsibilities include assessing and interpreting customer needs, requirements and medical records, as well as reviewing medical claims for medical necessity.Required skills and qualifications include:Active PHRN and USRN Mainland License1 year Bedside...

OverviewPosition SummaryWe are seeking a highly skilled and detail-oriented Peer Review Specialist to support our Residential, PHP, and IOP levels of care. This individual will be responsible for conducting peer reviews, case consultations, and interfacing with insurance payers to obtain continued authorization. The ideal candidate will be a licensed...

Healthcare SpecialistWe are seeking a qualified professional to fill a clinical review and adjudication role. The ideal candidate will have experience in clinical review, excellent verbal and written communication skills, and be able to work independently with minimal supervision.Clinical Review Nurses – Conduct clinical reviews of cases not meeting...