- Spectrum Billing Solutions (Skokie, IL)
- …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review ( UR ) Specialist to our growing team. ... The UR Specialist will utilize his or her knowledge and skills...clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and… more
- Community Health Systems (Birmingham, AL)
- …appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for ... Utilization management is the analysis of the necessity,...of denials. To provide leadership and oversight of the UR team. Coordinates insurance specific duties including CURP protocol.… more
- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …leadership, teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical ... level of care, length of stay, authorizations and denials for patients. The UR Specialist is responsible for contacting external case managers/managed care… more
- HonorHealth (Scottsdale, AZ)
- …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
- Reno Behavioral Healthcare Hospital (Reno, NV)
- The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The ... duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency...of care that may be covered. + Monitors all utilization reports to assure compliance with reporting and turnaround… more
- Trinity Health (Maywood, IL)
- …location is Loyola campus. Position is hybrid, local candidates preferred. The **Regional Utilization Review Documentation Specialist ** nurse works with the ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Utilization Review - RN Reviewer- Regional Coverage...coverage. The position includes but not limited to basic UR job duties such as level of care determination,… more
- Tufts Medicine (Lawrence, MA)
- …**Job Overview** Responsible for assisting the Manager of Patient Access, Utilization Review , Accounts Receivable and Medical Records/Health Information ... 2. Five (5) years of experience in accounts receivable and/or utilization review **Preferred Qualifications:** 1. Supervisory/management experience 2. Seven… more
- University of Rochester (Rochester, NY)
- …any investigations and corrective action plans as it relates to HazD handling and utilization within the health system. Documents the review of the quality ... 40 Department: 100124 Environmental Health & Safety Work Shift: UR - Day (United States of America) Range: ...UR - Day (United States of America) Range: UR URG 111 Compensation Range: $63,815.00 - $95,723.00 _The… more
- Nuvance Health (Norwalk, CT)
- …principal liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and Health Information Management to ensure ... coming in from other hospitals. Responsibilities: 1. Manages the Utilization Review elements of the ED encounter...pertinent information to Care Coordination colleagues. 14. Collaborates with UR Specialist to complete the process for… more
- Tufts Medicine (Lawrence, MA)
- …position is responsible for assisting the Manager of Patient Access, Utilization Review , Accounts Receivable and Medical Records/Health Information Management ... the delivery of support services or activities, typically under supervision. A specialist level role that requires very advanced knowledge of operational procedures… more