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Claims Review Nurse jobs

Viewing 1 - 10 of 52 jobs

  • Sr. Worker's Comp Claims Examiner

    Superior Group - Anaheim, CA

    * Administer Worker's Compensation benefits to injured Cast Members to include investigation, review/analysis of medical ... care and Vocational Rehabilitation. * Investigation of claims * Medical management to include working with Nurse...

    6 days ago from Superior Group

  • Fraud Investigator II, Healthcare Provider Review

    Commonweatlh of Massachusetts - Boston, MA

    Provider ReviewFraud Investigator II, Healthcare Provider Review Agency Name: University of Massachusetts Medical ... data mining and data analysis techniques utilizing claims data to detect aberrancies and outliers in claims and...

    11 days ago from Commonweatlh of Massachusetts

  • 2VP, Complex Claim Liability Specialist - Public Sector Job

    Travelers - Hartford, CT

    for specific activities required to effectively evaluate claims, such as Subro, Risk Control, nurse consultants and ... claims within delegated authority. Negotiate disposition of claims with insureds and claimants or their legal...

    18 days ago from Travelers

  • RN, Retrospective Reviewer

    Holy Cross Hospital - Columbus, OH

    an understanding of third party contract requirements for claims, utilization review and appeal processing. ... denials. Trains other departments in payer utilization review and claims submission requirements, and medical...

    18 days ago from Holy Cross Hospital

  • Registered Nurse (RN) - Medical Review & Appeal RN

    Palmetto Health - Columbia, SC

    accurate closing documents. Performs medical documentation review and bill audits and resolves charge capture inquiries ... Must have experience with electronic medical record review. EEO/AA Job 32738...

    20 days ago from Palmetto Health

  • RN, Retrospective Reviewer

    Mount Carmel Health System - Columbus, OH

    an understanding of third party contract requirements for claims, utilization review and appeal processing. ... denials. Trains other departments in payer utilization review and claims submission requirements, and medical...

    30+ days ago from Mount Carmel Health System

  • Fraud Investigator II, Healthcare Provider Review

    University of Massachusetts Medical School - Charlestown, MA

    unit include compliance with the Surveillance Utilization Review Subsystem (SURS), development and running of ... data mining and data analysis techniques utilizing claims data to detect aberrancies and outliers in claims and...

    30+ days ago from University of Massachusetts Medical School

  • 2VP, Complex Claim Liability Specialist Job

    Travelers - Hartford, CT

    for specific activities required to effectively evaluate claims, such as Subro, Risk Control, nurse consultants and ... claims within delegated authority. Negotiate disposition of claims with insureds and claimants or their legal...

    26 days ago from Travelers

  • Director, Healthcare Services, RN

    Oregon Employment Department - Portland, OR

    as Customer Service, Professional Relations, Marketing, Claims and Compliance where there is shared ... curricula for HealthCare Coordination, Medical Review and Behavioral Health functional areas. * Ensure...

    10 hours ago from Oregon Employment Department

  • RN - Registered Nurse

    Portland, OR

    RN – Nurse Auditor $68,000 - $80,000 RN – Nurse Auditor Candidates must work at least 6 months in the office before ... coding audits, quality assurance assessments of claims, reviews statistical samples and analyzes for risk. Plan,...

    30+ days ago from Core Medical Group