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ExamWorks
ExamWorks
5 001 – 10 000 Xodimlar
HuquqKonsaltingSog‘liqni saqlash

ExamWorks sog‘liqni saqlash, konsalting va yuridik xizmatlar kesishgan sohada faoliyat yuritib, da’volar va ular bilan bog‘liq jarayonlar uchun mustaqil tibbiy ko‘riklar hamda ekspert baholashlarini taqdim etadi. Kompaniya faoliyati hisob-fakturalarni ko‘rib chiqish, Medicare talablariga muvofiqlikni ta’minlash, tibbiy yozuvlar va hujjatlarni boshqarish hamda muvofiqlik auditlarini ham qamrab oladi.

Kompaniya shifokorlarning keng tarmog‘ini qo‘llab-quvvatlaydi va sog‘liqni saqlash tashkilotlari uchun korporativ platformalar hamda ish jarayonlarini boshqarish vositalarini ishlab chiqadi. Uning jamoalari klinik, operatsion, muvofiqlik va texnologik tajribani birlashtirib, mijozlarga tibbiy yozuvlar va da’volarni yanada izchil hamda ishonchli boshqarishda yordam beradi.

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Kompaniyadagi ish o‘rinlari

Utilization Review Nurse Auditor — New Jersey Remote

ExamWorks is hiring a remote Utilization Review Nurse Auditor in New Jersey to assess medical necessity and authorize appropriate care. The role supports accurate, compliant utilization determinations, provider communication, and review documentation.

USAmerika Qo‘shma ShtatlariNJNyu-Jersi
33 $ – 46 $ / soat
MasofaviyTo‘liq stavkaO‘rta darajaSeniorTalab Qilinadigan Til: inglizchaAuditor

Tavsif

  • Conduct high-quality utilization reviews using evidence-based guidelines
  • Authorize medically necessary and appropriate care
  • Prepare peer review reports, correspondence, addenda, and supplemental reviews
  • Collaborate directly with providers to determine the level, intensity, and duration of care
  • Assess medical necessity based on care frequency, intensity, and required duration
  • Complete reviews according to industry quality standards and required turnaround times
  • Stay current on URAC and applicable state and federal regulatory requirements
  • Maintain accurate utilization review records in the designated database
  • Guide Customer Service Representatives in delivering determination letters on time
  • Support the resolution of client complaints and quality assurance matters
  • Ensure adherence to ERISA, URAC, and other applicable guidelines
  • Provide management with observations about compliance concerns
  • Attend company meetings, training sessions, and continuing education activities
  • Complete other assigned responsibilities

Talablar

  • High school diploma or equivalent is required
  • Completion of an accredited nursing program
  • An active, unrestricted Registered Nurse, Licensed Practical Nurse, or Licensed Vocational Nurse license is required
  • Current coding certification in OASIS, RAC-CT, CCS, CPC, RHIT, or RHIA is required
  • CPMA certification is preferred
  • Three to five years of direct professional patient-care experience
  • Utilization management experience is preferred
  • Strong understanding of medical terminology, anatomy and physiology, treatment protocols, medications, and laboratory values
  • Typing proficiency of at least 40 words per minute
  • Ability to use standard office equipment, including computers, fax machines, copiers, scanners, and telephones
  • Working knowledge of Microsoft Suite and multiple software applications
  • Ability to protect confidential information
  • Ability to work independently, prioritize tasks, and manage time effectively
  • Ability to perform under pressure while handling interruptions and unexpected situations
  • Ability to follow company policies and procedures

Imtiyozlar

  • Medical insurance coverage
  • Vision insurance coverage
  • Dental insurance coverage
  • Paid time off
  • 401(k) plan
  • Continuing education requirements
  • Company meetings and training activities
  • Fully remote work arrangement
  • Competitive benefits

O‘xshash ish o‘rinlari

NVIDIA

NVIDIA Senior Manager, Rack-Scale Systems Software Engineering

NVIDIA
H1B vizasi homiysiIshlab chiqarishSog‘liqni saqlashSun’iy intellekt
USAmerika Qo‘shma ShtatlariCAKaliforniyaWAVashington
248 000 $ – 391 000 $ / yil
OfisdaTo‘liq stavkaSeniorTalab Qilinadigan Til: inglizchaMuhandislik menejeri
C++GoKubernetesLinuxPythonRustTaqsimlangan tizimlar

Lead NVIDIA’s engineering team building rack-scale infrastructure software for AI computing systems. Drive control planes, lifecycle orchestration, reliability, and delivery across teams.

Ochish