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Claims Review Nurse jobs

Viewing 1 - 10 of 81 jobs

  • Fraud Investigator II, Healthcare Provider Review

    University of Massachusetts Medical School - Charlestown, MA

    data mining and data analysis techniques utilizing claims data to detect aberrancies and outliers in claims and ... experience. Knowledge of coding, reimbursement and claims processing policies. Knowledge of the principles and...

    18 days ago from Inside Higher Ed

  • Manager of SIU Medical Review Team

    General Dynamics - Towson, MD

    of workload, selecting random samples, performing medical review, interviewing members and/or providers, conducting ... will conduct reviews of medical records and associated claims in the course of fraud and abuse investigations or...

    30+ days ago from The Washington Post

  • Director of Claims (Medicare/Medicaid only)

    Nexus Healthcare - Detroit, MI

    the latest job opportunities. Job Description: The Director Claims establishes the overall strategic and operational ... service to customers. Direct assigned claims processing, review and adjustments as well as all claims related...

    2 days ago from ZipRecruiter

  • Nurse Auditor

    Pcs, Inc. - Professional Career Staffing - Houston, TX

    Job Description: Nurse Auditor – Houston, TX The Nurse Auditor will have full responsibility to audit patient charts ... 3. Works with outside auditors to review claims to ensure charges were billed appropriately. GROWTH/INNOVATION...

    24 days ago from ZipRecruiter

  • Director of Work Comp Claim (Major Case) Job

    Travelers - Hartford, CT

    lines and personal liability claims. (Personal liability claims are not applicable to the Construction organization.) ... claims handling practices. Insurance license(s) and/or nurse license as required by state regulation.

    10 days ago from Travelers

  • Construction Claims Associate Manager (Director Level Role) Job

    Travelers - California

    Job Opening ID 27BR Title Construction Claims Associate Manager (Director Level Role) Country US State/Region/Province C ... Extensive claim and/or legal experience and thus the technical expertise to evaluate severe and complex claims...

    16 days ago from Travelers

  • Claims Edit - Payment Policy Manager

    Boston Medical Center Healthnet Plan - Boston, MA

    existing medical policy efforts Supports medical policy review activities as it relates to new lines of business Leads ... Current MA state licensure as a Registered Nurse. Pre-employment background check Competencies, Skills, and...

    16 days ago from Boston Medical Center HealthNet Plan

  • Fraud Investigator II, Healthcare Provider Review

    Mass.gov - Boston, MA

    Job Description: Fraud Investigator II, Healthcare Provider Review. Fraud Investigator II, Healthcare Provider Review. ... data mining and data analysis techniques utilizing claims data to detect aberrancies and outliers in claims and...

    30+ days ago from ZipRecruiter

  • Director of Work Comp Claim (Major Case)

    Travelers Companies - Hartford, CT

    lines and personal liability claims. (Personal liability claims are not applicable to the Construction organization.) ... claims handling practices. Insurance license(s) and/or nurse license as required by state regulation.

    8 days ago from Job.com

  • Construction Claims Associate Manager (Director Level Role)

    Travelers Companies - Diamond Bar, CA

    of experience handling serious injury and complex liability claims preferred.Skilled in coverage, liability and damages ... thus the technical expertise to evaluate severe and complex claims.Thorough understanding of commercial lines products,...

    10 days ago from Job.com