CLINICAL QUALITY DATA ANALYST

Our client, a trusted U.S.-based organization specializing in independent medical evaluations, peer reviews, and healthcare compliance solutions, is seeking a Clinical Review Analyst to join their growing operations team. The company is recognized for combining advanced technology with clinical expertise to deliver accurate, efficient, and secure medical...

THE OPPORTUNITYOur client, a trusted U.S.-based organization specializing in independent medical evaluations, peer reviews, and healthcare compliance solutions, is seeking aClinical Review Analystto join their growing operations team. The company is recognized for combining advanced technology with clinical expertise to deliver accurate, efficient, and...

Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria,...

Signing bonus for new employeesSenior Clinical Coding Analyst - Onsite Manila Health Business Solutions, LLC We are seeking an experienced and detail-oriented Senior Clinical Coding Analyst to join our team and take on a crucial role in ensuring coding quality within our revenue cycle. As a Senior Clinical Coding Analyst, you will be responsible for...

Performs quality audits on clinical reviews needed to resolve and process appeals. Provides guidance on preparing case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal. Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards....

Data and Systems Analyst – Healthcare / EMR / CRM (Remote)We are seeking an experienced Data and Systems Analyst to support a growing healthcare and behavioral health organization. This role is responsible for auditing, extracting, analyzing, and reporting data from multiple systems to drive informed decision-making across clinical operations, admissions,...

Signing Bonus for new hiresClinical Coding Analyst Health Business Solutions, LLC  Manila (On-site)  We are seeking a detail-oriented and analytical Clinical Coding Analyst to join our team and take on the responsibility of reviewing claims denied for coding-related issues. As a Clinical Coding Analyst, you will play a critical role in identifying and...

The Role: The Clinical Data Manager (CDM) is responsible for clinical data management operations and activities such data review (Query management, data listings review etc.) including external lab vendor and SAE reconciliations. CDM is also responsible for EDC testing and data cleaning.The CDM should thoroughly understand the requirements for Good Clinical...

Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards.Roles and Responsibilities:Prepares case reviews for Medical Directors by researching the appeal,...

"Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards.Roles and Responsibilities:Prepares case reviews for Medical Directors by researching the appeal,...