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Claims Review Nurse jobs

Viewing 1 - 8 of 9 jobs

  • Nurse Investigator

    HealthNow New York - Buffalo, NY

    fraud/abuse through comprehensive medical record and claims review of all HealthNow contracted providers. ... Required Licenses/Certifications: Current NYS Registered Nurse license required Certified Professional Coder or...

    19 days ago from HealthNow New York Inc.

  • Registered Nurse/Reimbursement Analyst-Charge Capture, FT, M-F 8a-5p

    Tallahassee Memorial Healthcare - Tallahassee, FL

    established time frames * Analysis/oversight of audited claims pre-release to the applicable payer * Ensuring ... Utilization Review, Case Management, Payer Audits/Appeals) preferred, with knowledge of coding, billing, and reimburseme...

    30+ days ago from Tallahassee Memorial HealthCare

  • Nurse Coding Educator

    Premera Blue Cross - Mountlake Terrace, WA

    well as physicians. 2. Review medical records and submitted claims, summarize pertinent information and identify gaps ... coding systems that apply to medical documentation and claims. 8. Consults with Medical Directors, Provider...

    30+ days ago from Premera Blue Cross

  • RN - Clinical Analyst

    HealthNow New York - Buffalo, NY

    (DMV check will be conducted to review candidate's driving record) Must be able to accommodate regional/national travel ... Licenses/Certifications: NYS Registered Professional Nurse License required Driver's License/DMV Check required...

    30+ days ago from HealthNow New York Inc.

  • External Audit Investigator

    Portland, OR

    in pursuing recovery of inappropriate and/or insupportable claims Formulate audit report and identify and document ... policies and procedures relating to appropriateness of claims submittals, payment protocols, and other issues...

    1 day ago from Oregon Employment Department

  • Data Analyst - Medicare

    HP - Los Angeles, CA

    This individual will be required to review sophisticated data model output and/or perform additional analysis in effort ... and knowledge of health care information(e.g., health claims data specifically Medicare and Medicaid),...

    4 days ago from HP

  • Liver Transplant Coordinator

    Children's Medical Center - Dallas, TX

    meetings, quality assurance performance improvement (QAPI) review meetings, monthly departmental staff/education meetings, and participate in orienting fellows/residents. Education * Two-year Associate's degree or equivalent experience...

    30+ days ago from Children's Medical Center

  • Medical Services Appeals Adm

    Premera Blue Cross - Mountlake Terrace, WA

    processes between Medical Directors and the Clinical Review nurses for all lines of business and all geographic ... required by federal and state guidelines 10. Ensures timely review of all appeals mandated by regulatory and...

    30+ days ago from Premera Blue Cross

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