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Claims Review Nurse jobs

Viewing 1 - 10 of 1,564 jobs

  • Claims Administrative Clerk

    Health Choice - Phoenix, AZ

    provides administrative and clerical support to the Claims Management Team and the Claims Department. Assists Claims ... company: • Maintain and update Medical Review Log every day • Route pended medical claims to the Medical Review Nurse...

    24 days ago from MiracleWorkers.com

  • Clinical Claims Review LPN

    UnitedHealth Group - Green Bay, WI

    position is to review, evaluate, assess and analyze medical claims, pertinent medical information and/or medical records ... This is accomplished through appropriate collaborative review with internal consultants, medical resources and...

    10 days ago from UnitedHealth Group

  • Lead Medicare Claims Reviewer (RN)

    Catapult Consultants - Omaha, NE

    Abilities Required: • While performing the duties of this job the employee is regularly required to sit and use hands to finger, handle, or feel while typing at a computer keyboard. • The employee is occasionally required to stand, walk,...

    29 days ago from Catapult Consultants, LLC

  • Utilization Review Nurse

    American International Group - Dallas, TX

    Perform Utilization Review of workers' compensation claims, based on review criteria and protocols in accordance with state and regulatory agency compliance. Conduct prospective, concurrent and retrospective reviews to determine medical...

    8 days ago from American International Group

  • Medical Necessity Review RN

    Oregon Employment Department - 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...

    1 day ago from Oregon Employment Department

  • RN, Specialty Care Review(350289)

    Kaiser Permanente - Atlanta, GA

    Establishes & maintains contact w/case Mrg regarding requests & review status as appropriate ... srvs. Refers cases identified as risk Mgmt, peer review or quality issues to QAIR & Risk Mgmt. • Document Review...

    2 days ago from Kaiser Permanente

  • Medical Necessity Review RN(345592)

    Kaiser Permanente - Portland, OR

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

    3 days ago from Kaiser Permanente

  • PRN RN, Specialty Care Review - 25-29 hours(298140)

    Kaiser Permanente - Atlanta, GA

    • Establishes & maintains contact w/ case manager regarding requests & review status as appropriate ... as risk mgmt, peer review or quality issues to QAIR & Risk Mgmt. • Document Review Activities according to...

    5 days ago from Kaiser Permanente

  • RN, Targeted Review(344652)

    Kaiser Permanente - Atlanta, GA

    Refers the patient to the home care review team &/or social workers as appropriate ... Coordinates & assists the Specialty Care Review Srv Sup’v w/ongoing physician education...

    20 days ago from Kaiser Permanente

  • Quality Review/Audit Associate

    Kelly Services - Nashville, TN

    HEALTHCARE PROFESSIONAL- Quality Review/Audit Associate If you’re a healthcare professional seeking an exciting position ... Medical Office, Insurance, Quality Review, Audit Associate, Medical Office Assistant, Insurance Agent, Agent...

    15 hours ago from Kelly Services

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