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Claims Review Nurse jobs

Viewing 1 - 10 of 2,212 jobs

  • Clinical Claims Review Nurse

    UnitedHealth Group - Lisle, IL

    paced challenging area. The RN will review, and process claims for those issues that are clinically related to ... The nurse will maintain contact with Case managers for review of authorizations related to requested services and...

    1 day ago from UnitedHealth Group

  • Senior Professional Review Analyst RN (1765 300255)

    WPS - Madison, WI

    Senior Professional Review Analyst - RN Location: Madison, WI Job Status/Type: Employee, Full Time We are seeking a Seni ... of claims * Act as a resource for claims processors on claims of higher complexity * Assess departmental claims...

    2 days ago from HealthJobsNationwide.com

  • UM/Concurrent Review Nurse

    Catholic Health Initiatives - Federal Way, WA

    Summary The primary role of the Utilization Management/Concurrent Review Nurse is to review and monitor members’ utiliza ... appropriate referral to case management, and high dollar claims review. This position will be considered for...

    7 days ago from MiracleWorkers.com

  • Medical Review Nurse - Permanent Job

    Yoh - Santa Clara, CA

    Medical Review Nurse needed for a direct hire opportunity with Yoh's client located in Santa Clara, CA. Top Skills You ... and benefit determinations - Performs review of suspended claims for CPT, ICD-9/ICD-10, HCPCS coding, bundling issues...

    16 days ago from PharmaDiversityJobBoard.com

  • Utilization Management Nurse Reviewer - Care Transitions 14-419

    Medical Mutual - Toledo, OH

    Utilization Management Nurse Reviewer - Care Transitions 14-419 Job Title: Utilization Management Nurse Reviewer - Care ... QUALIFICATIONS: • Registered Nurse with 3 years recent nursing experience with State of Ohio • 3 years current medical/s...

    17 days ago from TweetMyJobs

  • Utilization Review Nurse - Full Time - Utilization Management

    Alaska Native Tribal Health Consortium - Anchorage, AK

    review information in computer. Communicates results to claims adjusters. Enters billing information for services. ... experience Utilization Review. Certification in Utilization Review or Utilization Management is preferred. ADDITIONAL...

    30+ days ago from HealthJobsNationwide.com

  • Utilization Review RN

    Dignity Health - Rancho Cordova, CA

    TYPE: Full Time HRS PER PAY PERIOD: 80 This position will review medical records, benefit, contractual and other guidelines to determine benefit coverage, medical appropriateness including, access, scope availability, and level of care...

    15 days ago from Jobg8

  • Utilization review nurse

    Dynamic Medical Consultants - Seattle, WA

    nurse for medical consulting company with utilization review and precertification experience. Prefer workers’ ... 8-9 hours daily of computer/phone time handling medical claims. This position is paid per medical report completed...

    11 days ago from ZipRecruiter

  • Medical Claim Review Medical Director - Virtual

    UnitedHealth Group - New York City, NY

    for the initial (MCR) post service clinical review of claims for UnitedHealth Group (UHG). The Medical Director ... other departments such as the preservice Clinical Coverage Review team and Inpatient Concurrent Review team regarding...

    29 days ago from UnitedHealth Group

  • Concurrent Review Nurse - Permanent Job

    Yoh - Santa Cruz, CA

    Concurrent Review Nurse needed for a direct hire opportunity with Yoh's client located in Santa Cruz, CA. Top Skills ... - Perform preauthorization, concurrent and post-service review for all acute, sub-acute , skilled nursing facilities...

    17 days ago from PharmaDiversityJobBoard.com

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