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Reporting to the Premium Audit Supervisor, the Premium Audit Reviewer is responsible for the quality and timely review of all premium audits, including complex, out-of-state and key accounts, in accordance with company, industry and government rules and regulations.After an initial training perio...

... medical community. * Determine the appropriateness of data and references used to support promotional claims and marketing messages and provide proactive recommendations and/or guidance for ...

This individual will be responsible for reviewing, researching, and resolving all types of client deductions in an efficient and timely manner Responsibilities: * Will work to track, research ...

Participate in pre-startup safety reviews to ensure that pre- and post- process safety related actions, including PSI related ones, are completed. * Work with project engineering team to ensure that ...

About the job: - Consult with patients to learn about their physical condition and symptoms and review their medical history and referrals from doctors or surgeons - Diagnose movement dysfunction by ...

Supervise compliance with terms of agreements in lieu of discipline (AILODs or "diversions") statewide (both OAE cases and those of DECs), acting as primary attorney reviewer and decision maker for ...

Check out our industry leading reviews on Google and Indeed to see how much our clinicians enjoy working with us! · Benefits: AMS offers an array of benefits for any employee working 30 hours or ...

Reviews patient medical history, identifies/documents medical concerns, and obtains consents as appropriate. * Performs vital signs and routine lab testing, i.e., hemoglobin, HIV, pregnancy, urine ...

The Analyst Trainee position may also review and approve payment requisitions and funding agreement actions for multiple New Jersey Water Bank funded projects and programs, as well as ensure ...

Applications will be reviewed on a rolling basis until the position is filled. **Lower Bucks Hospital is an equal opportunity employer. We celebrate diversity and are committed to creating an ...

General Responsibilities Drafts or provides legal review of public notices, legal memoranda, settlement agreements, contracts, resolutions, rules, regulations, by-laws, affidavits, public hearing and ...

In addition to the traditional roll-up your sleeves tax review and client advisory, the role requires a strong sense of entrepreneurship, strategy, and management. We rely heavily on our local ...

Reviews monthly balance sheets, profit and loss statements, and analyzes against budget/forecast. Prepares audit supporting memos and high-level financial analysis to support key financial judgement ...

We have several policies that prevent confusion about what's expected from nurses before they begin a contract; one crucial item is an Engagement Letter review completed with your recruiter before ...

Content Review and Approval: * Coordinate with cross-functional teams, including legal, medical, and regulatory (MLR), to ensure content meets all compliance standards. * Facilitate the review and ...

Maintain a system for review and verification of credentials of staff prior to hire and as needed. * Participate in the annual budgeting process. Monitor revenue and expenses monthly and ensure ...

Entering review results online using your own tablet while on the job site. Training will be provided on how to enter a Quality Review Report in the report database. Reviewers are not required to ...

Performs chart review of identified patients to identify quality, timeliness and appropriateness of patient care. * Conducts admission reviews for Medicare, Medicaid beneficiaries, as well as private ...

Writing and researching legal issues for briefs, pleadings, ascertaining experts and preparing and reviewing discovery. * Provide guidance and counsel to clients through effective communication

Download and review court calendars, manage scheduling, and prepare necessary documentation. * Call clients prior to hearings to confirm attendance and directions. * Recognize retaliation claims and ...

... with reviewing and approving of Payer regulated content prior to it being used. • Supports the development of AMCP standard and pre-approval dossiers, Medicaid formulary requests, and custom ...

Lead the strategic and tactical development of clinical trial programs, including protocol design, data interpretation, and literature reviews. * Ensure clinical trials comply with regulatory ...

Responsible for the independent review of TPA trigger reports, claim referrals or similar information identifying potential catastrophic diagnoses or cases of concerns regarding potential cost ...

Utilization Review * Discipline: RN * Duration: 17 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Local Contract **Candidates can live anywhere within the state of New Jersey