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Third Party Verification Specialist

Pozent - Philadelphia, PA
Proficient in Basic Microsoft Office applications Required Required 3- 5 years Medicaid/Medicare Medical rules and regulations; claim processing and procedures Required 3 Years Required knowledge of system applications including Microsoft Office ... - Jun 25

Clinical Care Reviewer - UM

Poz - Harrisburg, PA
... Clinical Care Reviewer UM Job Summary The primary purpose of the job is to:Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing ... - Jun 25

DME Specialist

Poz - Harrisburg, PA
... Responsible for intake specialist duties, Durable Medical Equipment responsibilities, as well as assisting with the orientation and training of intake specialists. Principal Accountabilities:1. Under the direction of the supervisor, assists in ... - Jun 25

HEDIS Specialist

Pozent - Harrisburg, PA
... Experience with abstracting clinical information from medical records - Required Experience with the use of Windows-based PC applications with emphasis on word processing, database, and spreadsheet software. - Required Knowledge of NCQA HEDIS ... - Jun 25

Behavioral Health Medical Dir

Pozent - Baton Rouge, LA
MD RequiredPosition Qualifications/RequirementsPhysician with a current unencumbered license through the State Board of Medical ExaminersBoard Certified Psychiatrist with an unrestricted license to practice in Louisiana and any other applicable ... - Jun 25

Provider Maintenance Tech

Pozent - Philadelphia, PA
... to use MS Excel to manage work items and manipulate data.Previous experience working with healthcare providersProficiency with medical terminologyPrevious experience working with Facets preferredPrevious experience working with EXP Macess preferred. ... - Jun 25

Prior Auth Coord - REG

Pozent - Atlanta, GA
Experience in a related clinical setting- 3 years Required Managed care or utilization review experience - Highly Desired A medical doctor/registered nurse or physician’s assistant- Required Must reside in Atlanta, GA - Jun 25

UM Tech

Pozent - Harrisburg, PA
... Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct medical management do not contain incentives, directly or indirectly, that encourage barriers to care and service in making determinations Principal ... - Jun 25

Community Care Manager

Poz - Philadelphia, PA
... Community based experienced home based work, willing to work with members who have complex behavioral, social and medical needs Care manager experience preferred Familiar with Philadelphia The primary purpose of the job is to: As part of the ... - Jun 25

Administrative Assistant

Pozent - North Charleston, SC
... • Assists in researching, organizing and formatting materials for corporate assignments to the Medical Affairs Management Team. - Jun 25
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