Clinical Reviewer

Job Role:The Clinical Utilization Review Specialist USRN position involves reviewing patient records to ensure medical necessity and quality of care. This role requires expertise in utilization management, with a strong background in workers' compensation and healthcare provider appeals.Main Responsibilities:Review patient records for medical necessity and...

Peer Reviewer Opportunity in Clinical MicrobiologyWe are seeking qualified experts to assess and provide feedback on academic manuscripts in the field of clinical microbiology.As a peer reviewer, you will play a vital role in maintaining the integrity and quality of published research. Your expertise will help authors refine their work, ensuring it meets the...

Job Title: Clinical Content SpecialistWe are seeking a skilled Clinical Content Specialist to join our team.Role Overview:The Clinical Content Specialist will conduct research and identify relevant medical coding and billing documents to enhance our automated claims editing solution.The ideal candidate will collaborate with medical professionals to obtain...

Job DescriptionThe role of the Care Account Specialist is a critical position that bridges enterprise client expectations with internal clinical standards and operational excellence. As the key clinical operations representative, you will act as the main point of contact for assigned enterprise clients, ensuring exceptional delivery of clinical services...

Job OverviewThe primary objective of this role is to provide dedicated support to the Private Duty Nursing (PDN) Director of Nursing in overseeing clinical operations for home care services.This position entails assisting with documentation, compliance, scheduling, and care coordination to ensure the PDN program runs efficiently and aligns with regulatory...

Job OverviewOur organization seeks a detail-oriented individual to fill the role of Peer Review Specialist. The selected candidate will be responsible for conducting peer reviews, case consultations, and interacting with insurance payers in order to ensure seamless care delivery.Main ResponsibilitiesConduct thorough peer reviews and clinical case...

At a leading healthcare organization, we specialize in recruiting and managing high-caliber staff for dynamic and growing facilities. Leveraging our extensive network, we connect clients with highly qualified professionals, offering tailored services to meet their unique needs.The Opportunity:We are seeking an experienced Medical Reviewer to join our team In...

Job Title: Healthcare Analyst Role SummaryWe are seeking a detail-oriented and analytical Healthcare Analyst to support clinical and coding operations through accurate data analysis, involving Hierarchical Condition Categories (HCC), Risk Adjustment Factor (RAF) scoring, and healthcare claims review.

Job Role OverviewClinical process specialists play a crucial role in ensuring the delivery of quality patient care. In this capacity, you will be responsible for reviewing patients' medical charts and determining the appropriate course of action.ResponsibilitiesThe ideal candidate will possess strong analytical skills, with the ability to review complex...

Job Overview">Our organization is seeking a diligent and detail-oriented Quality Assurance Nurse to join our team. This individual will be responsible for reviewing clinical documentation and timesheets for accuracy and quality, ensuring that our records are error-free, grammatically correct, and aligned with the plan of care.Key Responsibilities:Review...