Prospective Chart Reviewer Job at Randstad (Whitefield)

Prospective Chart Reviewer

Prospective chart reviewers help to identify clinical alerts in a patients' hist...

Location

India , Bengaluru

Salary:

Not provided

Randstad

Expiration Date

August 19, 2026

Requirements

1+ years of clinical experience required
Advanced level of clinical knowledge associated with chronic disease states required
Relevant chart review or coding experience required
ICD 10 experience required
Medical Doctor / Physician
Coding Certification through AHIMA or AAPC added advantage

Job Responsibility

Performs pre-visit medical record reviews to identify chronic conditions reported in prior years
Identify diagnoses that lack supporting documentation
Prioritizes clinical alerts and presents those that are strongly suggestive of an underlying condition
Present information to providers in a concise complete manner
All other duties as assigned

Fulltime

New

Clinical Nutrition Manager II

The Health and Wellness Manager is responsible for assigned health and wellness ...

Location

United States , Elon

Salary:

Not provided

Aramark

Expiration Date

Until further notice

Requirements

Bachelor's degree from a 4-year university or college in nutrition
Registered Dietitian credential with the Commission of Dietetic Registration
Licensed Dietitian status, if residing in a state with licensure
Strong communication skills: oral, written, and presentation
Ability to communicate with a wide range of people and behavior styles
Solid strategic, analytical, and decision making skills
Self-starter, confident in abilities, self-motivated and able to work effectively with little supervision
Guest-centric approach to higher education restaurants and dining experiences
Creative and flexible in attitude/style to adapt to new situations in a dynamic environment
Strong value system, unquestioned integrity, and good listening skills

Job Responsibility

Works with internal recipe and menu programs and systems to post accurate menu ingredient and allergen transparency on digital media platform and maintenance of menu scheduling
Oversees FDA National Menu Labeling compliance as it relates to nutritional signage in on-campus residential and proprietary retail locations
Supports health and wellness platforms and implementation of programs such as tabling events, aiding in cooking demos, and other on-campus programming
Works with Guest Experiences Manager to engage the student population through social media and pop-ups events to drive participation
Supports contract retention efforts and client relations
Stays current and up-to-date on dining, nutrition and sustainability practices and trends
Maintains registration status through the Commission on Dietetic Registration and Licensure through the state board as applicable for DTR accredited candidates and maintain professional continuing education annually
Works with the culinary team to perform monthly or weekly kitchen and location recipe adherence audits
Partners with Safety Champion to engage employees and managers in educational in-service and pre-service meetings, and regular trainings to review proper food safety and allergen management procedures
Works with the culinary team to ensure guest’s dietary preferences are being accommodated as presented by any guest

Fulltime

Credit Analyst

Location

Czechia , Prague

Salary:

737000.00 - 1143000.00 Kč / Year

Citi

Expiration Date

Until further notice

Requirements

2-5 years previous experience in a financial institution with a focus on credit analysis and spreading software
Extensive knowledge of Generally Accepted Accounting Principals (GAAP) accounting, financial regulations, financial products, and credit analysis
Good verbal and written communication skills in English
Knowledge of accounting theory and ability to read and assess company financial statements
Excellent organizational skills, attention to detail, and the ability to complete assignments in a timely manner
Effective written and verbal communication skills
Ability to work independently and within a team
Proficient in various spreadsheet and word processing applications (Excel and Word are preferred), including the use of graphs, models and charts
Related banking experience preferred
Educated to degree level or equivalent

Job Responsibility

Work alongside credit underwriters and bankers in structuring and analyzing credit requests for new and existing clients
Spread financial statements in accordance with bank guidelines whenever required to prepare credit ratings on existing and prospective borrowers
Produce credit summaries analyzing the business, performing financial analysis, identifying strengths, and prevailing risk factors for the business to make appropriate risk and return decisions
Prepare company financial projections to assess the repayment capacity of clients
Provide preliminary analysis of simple to medium complexity credits, and coordinate with the Credit underwriters, risk partners and Relationship Managers
Present credit analysis to senior stakeholders and effectively answer questions when challenged
Ongoing early warning monitoring and the preparation of annual credit reviews for a portfolio of clients
Stay abreast of developments within the global economy and designated industries to support early warning monitoring
Work with colleagues globally to offer credit solutions to international subsidiaries understanding local market requirements
Maintain compliance with Citibank credit policies / practices and regulatory policies, to ensure the business unit is in adherence and receives satisfactory ratings from internal and external auditors

What we offer

competitive base salary (which is annually reviewed)
hybrid working model (up to 2 days working at home per week)
business casual workplace

Fulltime

Utilization Management Admissions Liaison RN II

The Utilization Management (UM) Admissions Liaison RN II is primarily responsibl...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Associate's Degree in Nursing
Minimum of 7 years of clinical experience in an acute hospital setting
Previous experience to have a strong understanding of Utilization Management/Case Management practices including, but not limited to, placement (with level of care) criteria (MCG, InterQual), concurrent review, and discharge planning
Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint
Provision of excellent customer service required due to frequent communication with providers and other members of the interdisciplinary team
Knowledge of personal computer, keyboarding, and appropriate software to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment
Prepare clear, comprehensive written and oral reports and materials
Excellent time management and priority-setting skills
Maintains strict member confidentiality and complies with all HIPAA requirements
Strong verbal and written communication skills

Job Responsibility

Provides the primary clinical point of contact for inpatient acute care hospitals requesting Inpatient care/post-stabilization admission requests, Higher level of care transfers and other emergent transfers or needs. Ensures appropriate determination for admission requests/HLOC transfers based on clinical data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission needs, including, but not limited to, bed and accepting physician availability
Establishes and maintains ongoing communication with internal stakeholders and external customers while securing the L.A. Care member's admission or inter-facility transfer. Interfaces with physicians, house supervisors, and other hospital delegates to ensure that telephone triage results in appropriate patient placement
Applies clinical expertise and the nursing process to triage and prioritize admission acuity, servicing as an expert clinical resource for patient placement while utilizing medical knowledge and experience to facilitate consensus-building and development of satisfactory outcomes
Continually seeks new ways to improve processes and increase efficiencies. Takes the initiative to communicate recommendations to UM Leadership
Completes all inpatient and discharge planning requests appropriately and timely including, but not limited to: Skilled nursing facility, outpatient needs (home health, physical therapy, infusion), and case management referrals
Performs prospective, concurrent, post-service, and retrospective claim medical review processes. Utilizes clinical judgement, independent analysis, critical-thinking skills, detailed knowledge of medical policies, clinical guidelines and benefit plans to complete reviews and determinations within required turnaround times specific to the case type. Identifies requests needing medical director review or input and presents for second level review
Performs other duties as assigned

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Director, Provider Education & Risk Adjustment

The Physician Educator serves as a liaison between the Health Plan and the parti...

Location

United States , New York

Salary:

175000.00 - 200000.00 USD / Year

MJHS

Expiration Date

Until further notice

Requirements

Bachelor's Degree required or comparable work experience will be considered
Minimum 5 years of experience in professional services, including practice management, nursing, clinical documentation improvement or quality audit
2-3 years of teaching experience in a clinical setting preferred
2-3 years of progressive leadership experience preferred
Extensive knowledge of coding and documentation requirements including ICD-10-CM, CPT-4, and HCPCS
In-depth knowledge of medical terminology, anatomy and physiology, pharmacology, and pathology required
A general understanding of Health care insurance and Medicare managed care is highly preferred for this position
Excellent verbal and written communication skills, analytical skills, and organization skills required
Extensive problem-solving experience is required
Experience working with physicians and physician practices

Job Responsibility

Develop and maintain collaborative relationships with assigned providers/practices within Elderplan Network
Coordinate and present education of providers/practices related to risk adjustment, coding, and clinical documentation improvement
Assess workflow processes in physician practices that impact the ability to maximize Health Plan revenue achieved through the various risk adjustment payment models
Identify trends and barriers that interfere with correct coding and documentation practices in the physician practice sites, including but not limited to workflow, electronic health records, and clearinghouses
Adhere to CMS coding and documentation guidelines
Analyze medical record documentation and coding through a chart review process that identifies incorrect coding, coding lacking supporting documentation, and missed opportunities to capture risk adjustment diagnoses and associated revenue
Analyze and distribute reports to providers that summarize their performance related to coding and documentation and risk adjustment
Develop and implement strategic action plans based on findings of assessment of physician practice workflows and medical record documentation reviews
Maintain confidentiality of chart review results and member information
Maintain a current and in-depth knowledge of CMS guidelines related to risk adjustment, coding, documentation, as well as knowledge of new models of risk adjustment that impact Health Plan revenue

What we offer

Tuition Reimbursement for all full and part-time staff
Generous paid time off, including your birthday
Affordable and comprehensive medical, dental and vision coverage for employee and family members
Two retirement plans! 403(b) AND Employer Paid Pension
Flexible spending
Paid Student Loan Forgiveness Program (PSLF)

Fulltime

Business Consulting Accounting Manager

We are seeking a Manager to join the Abdo business consulting team. If you have ...

Location

United States , Edina

Salary:

95000.00 - 130000.00 USD / Year

Abdo

Expiration Date

Until further notice

Requirements

Bachelor’s degree in accounting, finance, or related field
5+ years experience working in accounting
CPA preferred
Accounting experience in the following industries preferred: manufacturing, agriculture, professional services, real estate, and construction
Skilled in controller services, process optimization, long-term financial planning, budgeting, cost management, and software implementations
Experience in project and change management
Proficient in advanced MS-Excel functions (e.g. VLOOKUP, H-LOOKUP, SUMIFS, conditional statements (IF, MAX, MIN), pivot tables, graphs and charts)
Strong quantitative analysis and financial modeling skills, with a focus on improvement and automation
Experience with Quickbooks, Syft and/or Martus Solutions preferred
Desire to work in a fast-paced environment

Job Responsibility

Act as a fractional Controller for multiple clients: oversee monthly close, prepare management reports, join leadership meetings, and help improve overall business performance
Lead special accounting projects such as budgeting and forecasting, process and internal control reviews, and KPI/dashboard development
help clients work through complex financial issues
Advise clients on multi-year strategic accounting and finance needs
support them through process and systems changes
Serve as the QuickBooks Online expert: support implementations, conversions, system setup, and user training in coordination with our Financial Solutions team
Provide guidance on the financial and tax implications of business decisions and identify when to involve the tax team for more complex issues
Present financial results to leadership teams with clear insights
Ensure year-round audit readiness with clients
Perform compilation engagements, including GAAP and tax accounting matters, financial statement preparation, and related footnote disclosures

What we offer

Medical, dental, vision, HSA with employer match, FSA medical and dependent care, long & short-term disability insurance options
22 days per year of PTO, 8 full holidays, 2 half holidays, 24 hours paid volunteer time, parental and grandparent leave
401(k) plan with employer contributions up to 4.5%
Abdo-sponsored telehealth platform
Technology reimbursement
Half day Fridays June through September
Professional expenses and CPA support and bonus

Fulltime

Sales Enablement Specialist

The Sales Enablement Specialist is responsible for leading the collaboration wit...

Location

United States , Bonita Springs

Salary:

85000.00 - 95000.00 USD / Year

Rittenhouse Village At Michigan City

Expiration Date

Until further notice

Requirements

Bachelor’s Degree in business, finance, or related field
Four years in a business analyst role
Multifamily or Senior Living experience a plus
Ability to communicate effectively in writing and verbally at all levels of the organization
Ability to read and interpret documents, including procedural manuals and training materials
Ability to write reports and correspondence communication
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals
Ability to compute ratios, percentages, and comparisons to properly evaluate data
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form
Ability to deal with problems involving several concrete variables in standardized situations

Job Responsibility

Collect and analyze data to identify sales opportunities, assist with revenue driving strategies, and provide insight on market conditions
Analyze business results and work with the sales team and other departments (Marketing, Business Intelligence, Finance and Operations) to increase the prospect base, identify strengths and weaknesses in current business tactics, and provide suggestions for improvements, as necessary
Using established metrics, design and deliver predictive models for sales activities and move ins
Develop, evaluate, and improve methods of data collection and analysis
Prepare complex reports of metrics and analysis and communicate findings and recommendations to the appropriate stakeholders
Manage multiple projects to completion with minimal guidance and with collaboration across multiple disciplines
Identify opportunities and collaboratively develop solutions with the appropriate stakeholders
Develop and maintain sales analytics reports and dashboards to provide actionable insights that support data-driven decision-making for the sales and executive leadership teams
Partner with sales leadership to define and operationalize key Sales KPIs to build measurement and tracking tools to put data at the center of decision making
Create compelling presentations and effectively communicate findings on key trends, insights, and implications while aligning stakeholders on action plans

Fulltime

Chart Retrieval Specialist

You'll retrieve medical records from various healthcare facilities on behalf of ...

Location

United States , Seattle

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High School diploma or GED
A valid driver's license
Insurance/liability policy in the team member's name
Reliable and secure internet with the ability to download 50 Mbps and upload 5 Mbps
Meticulous attention to detail
Strong interpersonal skills
Know how to download / upload files and store them in an organized file
Ability to transfer files from software to a desktop folder
Know how to copy and paste files, i.e., transfer files to a flash drive
Lift and carry chart boxes efficiently without putting your back and other muscles at risk

Job Responsibility

Retrieve medical records from various healthcare facilities on behalf of health plans and other clients for retrospective and prospective reviews
Scan Medical Records/Charts and upload into the system office after the day is completed
If you have anything left to submit at the end of the day, you can do it from the comfort of your home

What we offer

Medical
vision
dental
life and disability insurance
401(k) plan
free online training

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Prospective Chart Reviewer

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Prospective Chart Reviewer

Prospective Chart Reviewer

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