Showing 1-10 of 276
Showing 1-10 of 276
Reviewer medical necessity jobs

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Kepro - Salem, OR

RN Clinical Reviewers*. Knowledge of the organization of medical records, medical terminology, and disease process required....

Alameda Health System - Oakland, CA

Medical necessity and where appropriate work through the hospital HIM and financial departments to identify physician and clinic practices that require improved...

One Call Care Management - Tampa, FL

Clinical Reviewer - Dental. Perform Clinical Reviews of patients' treatment by analyzing all therapy documentation and peer-to-peer communication to determine...

UniCare - Remote

Provide timely medical necessity review the pre-certification and concurrent review as well as appeals. Is responsible for supporting the medical management...

St. Vincent’s Health Services - Bridgeport, CT

Reviews admission and service request for prospective and current retrospective medical necessity and/or compliance with reimbursement policy criteria....

Monarch Shores - San Juan Capistrano, CA

Possess sufficient clinical knowledge to effectively communicate the medical necessity of treatment with insurance reviewers in order to obtain authorization...

Anthem, Inc. - Deerfield, IL

Determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review....

Anthem, Inc. - Glendale, AZ

Determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review....

Execu | Search - New York, NY

Refers all cases that do not meet medical necessity criteria to a physician reviewer for consideration, ensuring the timely review of the referred case....


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