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Claims Review Nurse jobs

Viewing 1 - 10 of 30 jobs

  • Medical Director, Claims Centralized Operations

    Geina O'malley Company - Spokane, WA

    Centralized Operations will be a Subject Matter Expert on Claims and be a  Clinical Resource within the Claims ... Fraud / Waste / Abuse Managed Care / Healthcare Medical Claims Review   Duties will include but are not limited to:...

    30+ days ago from TheLadders.com

  • 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

  • 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

  • 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

  • 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.

  • UR Services Nurse

    York Risk Services Group - Austin, TX

    JOB SUMMARY: Review of medical requests for treatment (state mandated Utilization Review). Not all requests should be ... ACOEM. Medical expertise (licensed Nurse) is required to review the requests for service. ESSENTIAL JOB...

    30+ days ago from York Risk Services Group Inc.

  • 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

  • TCM Nurse

    York Risk Services Group - El Dorado Hills, CA

    Review UR treatment requests for medical necessity Complete the UR process - medical documentation Review Claim Examiner ... Communication with the Claims Examiner, Claims Managers, UR Medical Coordinators and physician offices when...

    30+ days ago from York Risk Services Group Inc.

  • Workers Compensation Specialist

    Ptsystems - Beverly Hills, CA

    Job Description: Direct workers’ compensation claims handling for Fox companies Direct medical providers, nurse case ... Litigated Report. Prepare for and participate in claims reviews and annual audits. Prepare for and attend...

    14 days ago from Tech Fetch

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