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Claims Review Nurse jobs

Viewing 1 - 10 of 15 jobs

  • Utilization Review Operations Manager

    Managed Care Staffers - Richmond, VA

    Utilization Review Operations Manager. The Utilization Review Operations Manager oversees and coordinates all ... of Medical Assistance Services Minimum 2 years UM/CM/QI and claims review required...

    30+ days ago from TheLadders.com

  • Clinical Reviewer (RN) - FT Days

    Usr Healthcare - Lees Summit, MO

    is to create consistency and efficiency in inpatient claims processing and data collection to optimize DRG reimbursement and facilitate data quality in hospital inpatient services.Responsible for facilitating concurrent documentation of...

    30+ days ago from USr Healthcare

  • LVN

    Boson Health - Houston, TX

    to patients; filing, collecting, and expediting third-party claims. Maintains operations by following policies and ... Contributes to team effort by accomplishing related results as needed Saves physician/nurse practitioner’s time by helpi...

    2 days ago from Boson Health, LLC

  • Compliance Auditor (RN)

    Johns Hopkins Healthcare - Maryland

    range from validation audits on statistical samples of claims to determine whether medical services were accurately ... Medical record, coding, and/or billing audit review experience strongly preferred...

    2 days ago from Networks and Systems Professional Association

  • (LVN) Appeals & Grievances Nurse

    Medsearch Financial - Monterey Park, CA

    general understanding of clinical department operations and claims processing procedures. Interacts with external ... QUALIFICATIONS / REQUIREMENTS Current California Licensed Vocational Nurse...

    6 days ago from MEDsearch Financial, Inc.

  • Medical Director

    Fidelis Care New York - Rego Park, NY

    Essential Functions: Evaluates authorization requests in timely manner and provide support for the nurse reviewers and m ... process. Conducts concurrent and retrospective reviews of claims and appeals, and resolves grievances related to...

    30+ days ago from TheLadders.com

  • Senior Director Of Management Operations

    Eugene, OR

    and Preauthorization, Case Management, Care Transitions, Claims Review, Disease Management, Pharmacy Management, Behavioral Health Integration and Long Term Care. Guide managers and work teams to define workflows, eliminate waste, and...

    30+ days ago from Oregon Employment Department

  • Manager of Clinical Quality Improvement

    Pride Health - New York City, NY

    Manager of Clinical Quality Improvement About this Job Managed Care company is looking for a Manager of ... care (LTC) setting or managed long-term care or managed care plan; Geriatrics, Medical Surgical Nursing, Case Management...

    30+ days ago from PRIDE Health

  • Case Management Unit Manager

    York Risk Services Group - Howell, MI

    program through the triage review of injuries, utilization review, facilitation of return to work and medical case ... Required Experience EDUCATION: BA/BS Degree in Nursing Licensed registered nurse a plus Certified Nurse Case Manager des...

    30+ days ago from York Risk Services Group Inc.

  • Senior Director Of Medical Management Operations

    Eugene, OR

    and Preauthorization, Case Management, Care Transitions, Claims Review, Disease Management, Pharmacy Management, Behavioral Health Integration and Long Term Care. Guide managers and work teams to define workflows, eliminate waste, and...

    30+ days ago from Oregon Employment Department

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