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Claims Review Nurse jobs

Viewing 1 - 10 of 10,061 jobs

  • Claims Auditor

    Visiting Nurse Service of New York - New York City, NY

    with other Health plan departments to ensure claims are processed in accordance with established guideline ... of internal and Third Party Administrator's ("TPA") claims processing policies and procedures. Provides feedback or...

    20 days ago from Visiting Nurse Service of New York

  • Clinical Claims Review Nurse

    UnitedHealth Group - Lisle, IL

    paced challenging area. The RN will review, and process claims for those issues that are clinically related to ... The nurse will maintain contact with Case managers for review of authorizations related to requested services and...

    2 days ago from UnitedHealth Group

  • Utilization Review Nurse

    Tenet Health - Annapolis, MD

    may perform separate functions, the Personal Health Nurse (PHN) and Utilization Management Nurse (UMN) work within a ... health contracts: Preadmission review; Concurrent review; Retrospective review; Pre-certification/Pre-notification...

    30+ days ago from Tenet Health

  • Utilization Review - Managed Care Nurse - (UL RN)

    Nursesrx - Sitka, AK

    Job Description & Requirements Utilization Review - Managed Care Nurse - (UL RN) StartDate: ASAP Available Shifts: 8/10/ ... to apply. utilization review nurse, managed care nurse, utilization review RN, nurse, nursing, registered nurse,...

    30+ days ago from NurseCareerBoard.com

  • Registered Nurse- Utilization Review

    U.S. Department of Veterans Affairs - White River Junction, VT

    The Fee Services Utilization Review Nurse II makes program specific decisions that reflect the distinct and contributory ... * 1-Full-Time * 0610-Nurse * Active * https://ApplicationManager.gov..

    18 hours ago from U.S. Department of Veterans Affairs

  • Medical Review Nurse - Permanent Job

    Yoh - Santa Clara, CA

    Medical Review Nurse needed for a direct hire opportunity with Yoh's client located in Santa Clara, CA. Top Skills You ... and benefit determinations - Performs review of suspended claims for CPT, ICD-9/ICD-10, HCPCS coding, bundling issues...

    20 days ago from PharmaDiversityJobBoard.com

  • Utilization Review RN

    Judge Group - Chattanooga, TN

    denial interpretation for letters, retrospective claim review, and UM pre-certifications and appeals, Performs ... back periods, rider information and medical policy/medical review criteria preferred. Must be PC literate with...

    2 days ago from ZipRecruiter

  • Clinical Claim Review RN - Telecommute

    UnitedHealth Group - Maryland

    areas: Primary Responsibilities: * Reviews post service claims for clinical eligibility for coverage as prescribed ... Assets: * Utilization management experience * Chart review experience * Appeals experience * Milliman guidelines...

    7 days ago from UnitedHealth Group

  • Concurrent Review Nurse - Permanent Job

    Yoh - Santa Cruz, CA

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

    21 days ago from PharmaDiversityJobBoard.com

  • Clinical Claims Review LPN - US Telecommute

    UnitedHealth Group - Hartford, CT

    work.(sm) Primary Responsibilities: * Performing triage of claims based upon the readmission review criteria to include ... * Geriatric or Medicare experience. * Claims Review. * Medical Reimbursement. Careers with...

    8 days ago from UnitedHealth Group

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