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Claims Review Nurse jobs

Viewing 1 - 10 of 31 jobs

  • Utilization Review RN

    Clearday Healthcare Staffing - Hanover, MD

    looking to fill the following position: Utilization Review Nurse Education: Minimum Education - Bachelor's Degree Job ... preferred   Job Responsibilities: The Utilization Review RN is responsible for collaborating with healthcare...

    30+ days ago from TheLadders.com

  • Clinical Review Nurse

    York Risk Services Group - Dublin, OH

    established policies and procedures. The Clinical Review Nurse communicates results of clinical review and rationale ... review MedMetrics alerts and conducts clinical assessment review of claims to determine if they meet the criteria for...

    30+ days ago from York Risk Services Group Inc.

  • Sr. Claim Professional

    CUNA Mutual Group - Madison, WI

    Using precision interviewing/questioning, person will review and investigate disability claims by using the phone and wr ... such claims. This will include delegating/assigning these claims to junior level claim specialists for handling. 6.

    5 days ago from CUNA Mutual Group

  • Claims Vendor Analyst

    Boston, MA

    collaborative relationships with the staff within the Claims Department and across the entire organization * ... Reviews and monitors results of the vendors utilized within Claims to determine return on investment, metrics adherence...

    30+ days ago from The RightThing

  • Medical Services Review Coordinator

    York Risk Services Group - Austin, TX

    the reviews Interface with Ur Nurses/Medical Director and claims teams to staff cases Directs and plans the work of ... Knowledge of Utilization Review Regulations Knowledge of Claims/Utlization Computer systems Required Experience...

    30+ days ago from York Risk Services Group Inc.

  • HEDIS RN

    US Tech Solutions - Philadelphia, PA

    OCCUPATIONAL HEALTH NURSE, REGISTERED NURSE with Case Management Worker's Compensation experience. WORK 24 HOURS PER ... REVIEW AND DIRECTION OF CUSTOMER OPEN WORKER'S COMPENSATION CLAIMS. Other duties as assigned. Nabisco Bakery12000 E.

    12 days ago from US Tech Solutions, Inc.

  • RN/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

  • Athletic Trainer - PRN

    Usr Healthcare - Lees Summit, MO

    Lee's Summit Medical Center - Lee's Summit, MO Athletic Trainer - PRN Lee's Summit Medical Center is a full-service acute care facility serving Lee's Summit and surrounding areas. The 64-bed advanced technology facility is both an...

    12 days ago from USr Healthcare

  • Senior Nurse Case Manager

    Brickstreet Mutual Insurance - Naperville, IL

    competency. Collaborate with business team leaders and nurse case management technical professionals to identify nurse ... codes, as well as treatment protocols, in the review of claims decisions. Ability to maintain knowledge of current...

    3 days ago from Brickstreet Mutual Insurance

  • Medical Director

    Managed Care Company - Oak Brook, IL

    manages the denial process. Reviews cases with concurrent review nurses. Provides medical expertise for care ... Preferred Education: Board Certified (primary care preferred) Preferred Experience: Peer Review, medical policy/procedur...

    29 days ago from IvyExec

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