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Claims Review Nurse jobs

Viewing 1 - 10 of 1,579 jobs

  • Nurse Practitioner-Physician Assistant Job(59641837149)

    Wexford Health - Cumberland, MD

    Wexford Health has an exceptional opportunity for a Full-time Physician Assistant/Nurse Practitioner to join our team of ... As a Physician Assistant/Nurse Practitioner, you will have the opportunity to work in a setting that is unique, challeng...

    30+ days ago from Wexford Health

  • Registered Nurse Clinical Documentation Reviewer

    HCA Healthcare - Overland Park, KS

    is to create consistency and efficiency in inpatient claims processing and data collection to optimize DRG ... Qualifications Education: Registered Nurse, Bachelor’s preferred Licensure/Certifications: Current Kansas Nursing Licens...

    7 days ago from HCA Healthcare

  • Registered Nurse (Clinical Reviewer)

    U.S. Department of Veterans Affairs - Pearl, MS

    settings Clinical adjudication of emergency care claims Review clinically denied care with notice of disagreements ... REGARDING YOUR EXPERIENCE. VA Nurse Qualifications: Nurse I Level I - An Associate Degree (ADN) or Diploma in...

    3 days ago from U.S. Department of Veterans Affairs

  • Utilization Review Nurse

    Zagaruyka&associates - Oklahoma City, OK

    to the UM staff including consultation and support to nurse reviewers - Evaluates outcomes as a result of utilizing health status surveys with patients as well as through satisfaction questionnaires - Participates in interrater reliability...

    13 days ago from ZipRecruiter

  • RN or LMSW Manager Quality Improvement

    Tenet Health - Phoenix, AZ

    the liaison with the Health Plan Network Management, Claims, Medical Services, Finance, Member Services, Business ... experience required Preferred Education: Registered Nurse with Bachelor’s, Associate Degree, MSW, or person with other...

    5 days ago from

  • Referral Services LVN II

    Brown & Toland Physicians - San Francisco, CA

    Perform Utilization Review activities prospectively, concurrently or post-service (retrospective) for elective/urgent ho ... Generate required correspondence/review notification to patients, providers and health plans and formulate denial langua...

    25 days ago from Glassdoor

  • RN (Utilization Management) Non-VA Care Coordination

    U.S. Department of Veterans Affairs - Loma Linda, CA

    The duties and responsibilities of the UM/NVCC Nurse with specific role functions include, but is not limited to applyin ... and unrestricted registration as a graduate professional nurse in a State, Territory, or Commonwealth of the U.S. or...

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

  • PRN Patient Account Rep

    Tenet Health - Flagstaff, AZ

    documents the pertinent collection activity performed. Review the account information and necessary system applications ... to determine the next appropriate work activity. Verify claims adjudication utilizing appropriate resources and...

    10 days ago from

  • RN - Registered Nurse - Risk Management

    Core Medical Group - Seattle, WA

    The Senior Risk Manager is responsible for//incidents and claims issues, including investigation of incidents, loss control & mitigation, and support to litigation for assigned clinical service lines Assist the Director of Risk Management...

    2 days ago from

  • Care Manager, RN , Home Care / Hospice / Home Visit

    Independent Living Systems - Webster, NY

    determinations in accordance with Article 49-Utilization Review Ensures collection and review of required documentation ... Reviews clinical documentation, claims/utilization data to ensure members are receiving appropriate care and implement s...

    7 days ago from ZipRecruiter