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Claims Review Nurse jobs

Viewing 1 - 10 of 2,658 jobs

  • Health Plan Moms Utilization Reviewer

    Scott & White Healthcare - Temple, TX

    referrals from UM nurses, predictive modeling reporting, claims analysis, etc. Occasional home education visits may be ... criteria Through screening utilization review activity, review of predictive modeling report, claims reports, and upon...

    4 days ago from Scott & White Healthcare

  • Insurance/Medicare Documentation and Claims Specialist - Home Health

    Sterling Care - Greenwich, CT

    Job Description: The Insurance/Medicare Documentation and Claims Specialist role is to obtain insurance precertification ... The goal of concurrent review is to facilitate clinically appropriate physician/clinical documentation of all patient co...

    4 hours ago from ZipRecruiter

  • Workers Compensation Claims Examiner

    Dart Container - Stockbridge, MI

    standards. * Coordinate appropriate referral of claims for nurse case management services, transportation, translation ... claims, PIP claims, or other disability related claims * At least 2 years applying basic medical terminology...

    5 days ago from Dart Container

  • Utilization Review Nurse - Full Time - Utilization Management

    Alaska Native Tribal Health Consortium - Anchorage, AK

    review information in computer. Communicates results to claims adjusters. Enters billing information for services. ... experience Utilization Review. Certification in Utilization Review or Utilization Management is preferred. ADDITIONAL...

    8 days ago from

  • 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...

    14 hours ago from Jobg8

  • Account Claims Representative I - Workers Compensation

    PMA Companies - Mount Laurel, NJ

    Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve ... to clients, including face to face interactions during claims reviews, stewardship meetings and similar...

    8 days ago from

  • Utilization Review Nurse

    Judge Group - Elkridge, MD

    seeking an experienced Registered Nurse with Utilization Review experience for all full time permanent position. MUST ... NOT simply case management. Overview: The Utilization Review RN is responsible for collaborating with healthcare...

    9 days ago from ZipRecruiter

  • Medical Units Claim Manager Job

    Yoh - Fort Worth, TX

    Claims Manager Registered Nurse (RN) needed for a FULL TIME Permanent opportunity with Yoh's client that is located in ... of medical issues and treatment in workers' compensation claims. This position will review to authorize, partially...

    10 hours ago from Jobg8

  • Utilization Review Registered Nurse

    Judge Group - Syracuse, NY

    Judge Healthcare is actively seeking a Utilization Review Registered Nurse for an outstanding client of ours in ... Review service requests submitted by physicians to include review of evidence/clinical andmedical necessity.

    8 days ago from ZipRecruiter

  • Claims Processor II Job

    Yoh - San Diego, CA

    Reviewing/analysing/processing claim appeals - Determining claims risk and analyze claims for payment necessity and ... dealing with accurate review, input and adjudication of claims using common practice techniques Bonus Points!...

    14 hours ago from Jobg8

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