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Claims Review Nurse jobs

Viewing 1 - 10 of 8,254 jobs


    Dignity Health - San Francisco, CA

    General Liability (GL) and Professional Liability (PL) claims in the claims management system (iVOS); open claims in ... for annual claims review •Attend Risk Services Monthly meetings •Other tasks as directed by the ACMs Workers’...

    8 days ago from Dignity Health

  • Nurse Medical Case Mgr/Utilization Review - Workers Compensation

    Travelers - Buffalo, NY

    UR Nurse - Working as a Utilization Review Nurse, your medical training and experience as a licensed nurse, along with o ... jurisdictions. For nurses handling Workers Compensation Claims, perform Utilization Review according to established...

    30+ days ago from

  • Medical Director - Claims

    Nexus Healthcare - San Francisco, CA

    manages the denial process. Reviews cases with concurrent review nurses. Provides medical expertise for care ... Peer Review, medical policy/procedure development, provider contracting experience highly preferred 2147483647...

    30+ days ago from The Ladders

  • Case Mgr PRN

    HCA Healthcare - Thornton, CO

    through the continuum of care. Performs concurrent clinical review to determine appropriateness of admission and ... care setting. Performs telephonic clinical reviews with claims insurance personnel to facilitate reimbursement for...

    22 hours ago from HCA Healthcare

  • Nurse Practitioner-Physician Assistant

    Wexford - Galesburg, IL

    pharmacy, utilization management, provider contracting, claims processing, and quality management services. At ... This is for a Nurse Practitioner/Physician Assistant at the Hill Correctional Center, Galesburg, IL...

    3 days ago from Wexford Health

  • Concurrent Review Nurse - Permanent Job

    Yoh - Merced, CA

    Concurrent Review Nurse needed for a direct hire opportunity with Yoh's client located in Merced, CA. Top Skills Should ... - Perform preauthorization, concurrent and post-service review for all acute, sub-acute, skilled nursing facilities...

    17 hours ago from Jobg8

  • Case Manager - RN

    Dignity Health Medical Foundation - Santa Cruz, CA

    Description JOB ID: 1500016947 This position will review medical records, benefit, contractual and other guidelines to determine benefit coverage, medical appropriateness including, access, scope availability, and level of care...

    15 hours ago from Dignity Health Medical Foundation

  • RN - Clinical Programs Manager

    John Muir Health - Walnut Creek, CA

    authorization and referral services, concurrent inpatient review and discharge planning services. Oversees management ... and reimbursement issues. Responsible for resolving medical claims issues related to the UM process. Attends appropriate...

    4 days ago from John Muir Health

  • Nurse Practitioner-Physician Assistant - Mental Health

    Wexford - Leakesville, MS

    This is for a Mental Health Nurse Practitioner/Physician Assistant at South Mississippi Correctional Institution in Leak ... EDUCATION: Certification from an accredited college/university as an Advanced Practice Nurse or Physician’s Assistant...

    5 days ago from Wexford Health

  • Medical Necessity Review RN

    Kaiser Permanente - Portland, OR

    claims for clinically related issues to ensure accuracy of claims payment, in coordination with the Claims ... working relationships, and to position the Clinical claims review resources to effectively support organizational...

    28 days ago from Kaiser