Utilization Review Jobs in Maryland
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Search Results - Utilization Review Jobs in Maryland
University of Maryland Medical System-Baltimore
with and understanding of UMMS’ audit policy, process, practice and standards.
4. Provides concurrent review of charge capture prior to claim submission in order to maximize reimbursement and reduce revenue loss through audit process.
5. Works with the Director...
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MEDSTAR HEALTH-Baltimore
At this time, only registered nurses with prior Utilization Review or Appeals experience will be considered**
General Summary of Position
Responsible for coordinating and monitoring the denial management and appeals process. Combines clinical...
University of Maryland Medical System-Baltimore
and Midtown campuses, as well as to our adult psychiatric day hospital programs at UMMC Midtown.
Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care...
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JobGet Staffing-Columbia (MD)
requiring utilization review approval were reviewed and processed in accordance with utilization review decisions, - Deductibles, coinsurance and other appropriate cost-sharing features of the benefit plan were considered and correctly applied, - The claim...
Discovery Mood & Anxiety Program-Annapolis
program, and/or family weekend. Required to sit at a meal and/or snack a minimum of once per week.
Provides utilization reviews to insurance companies, providing appropriate clinical information to obtain initial authorization and continuing stay...
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1 similar job: Crownsville
Johns Hopkins Medicine-Baltimore
or utilization review.
• Accredited Case Manager-Registered Nurse (ACM-RN)/Certified Case Manager (CCM) preferred.
• Valid Maryland Nursing License required.
Important Notice: Authorization to Work in the United States: Applicants who require sponsorship now...
mindmatch.ai -
Ageatia Global Solutions-Baltimore
PURPOSE:
Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality of care.
ESSENTIAL FUNCTIONS:
35. ..
resume-library.com -
Nicolle Gonzales-Silver Spring (MD)
supervisory experience required. Experience in the development and management of quality, risk, and utilization review processes. Demonstrated leadership, communication, and analytical skills. Able to use computers. Reads, writes, speaks and comprehends...
appcast.io -
NCH Healthcare System-Potomac (MD)
Actively collaborates with utilization review team to facilitate and meet organizational and department goals. · Recognizes situations that require referral to quality or risk management and makes a timely referral. EDUCATION, EXPERIENCE AND QUALIFICATIONS...
CenterWell Home Health-Annapolis
documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed.
• Analyzes situations, identifies problems, identifies and evaluates alternative...
NCH Healthcare System-Bethesda (MD)
Actively collaborates with utilization review team to facilitate and meet organizational and department goals. · Recognizes situations that require referral to quality or risk management and makes a timely referral. EDUCATION, EXPERIENCE AND QUALIFICATIONS...
University of Maryland Medical System-Baltimore
for coverage; reviews hospital charges for accuracy, makes adjustments for duplicated or incorrect billing, as appropriate; calculates and determines level of patient benefit and enters appropriate proration into PMAS; forwards bill to third party payers...
resume-library.com -
Nicolle Gonzales-Germantown (MD)
supervisory experience required. Experience in the development and management of quality, risk, and utilization review processes. Demonstrated leadership, communication, and analytical skills. Able to use computers. Reads, writes, speaks and comprehends...
appcast.io -
Annapolis Junction
and optimizes Virtual Infrastructure Services to improve security, availability, performance, and resource utilization.
• Reviews current virtual infrastructures, architectures, designs, and operations to identify potential improvements.
• Analyzes, refines...
icims.com -
Baltimore County, MD-Towson
service programs.
• Complete utilization review activities for services through the Public Behavioral Health System (PBHS) Administrative Services Organization (ASO)
• Provide assistance to individuals calling the BBH HELP Call line.
• Determine needs...
surfingwave.app -
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