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Claims Review Nurse jobs

Viewing 1 - 10 of 9,536 jobs

  • Supervisor of Clinical Claims Review

    UnitedHealth Group - Greensboro, NC

    lives while doing your life's best work. (sm) Our Medical Claims Review area is the focal point of handling ... Keywords: RN, nurse, claims, managed care, insurance, medical review, supervisor, compliance, telecommute, work from...

    2 days ago from UnitedHealth Group

  • QRM Medical Review Manager(319971)

    Kaiser Permanente - Aurora, CO

    • Manages the activities of personnel in the Medical Review and claims department. • Coordinates specialized ... as a Registered Nurse, Nurse Practitioner, Physician Assistant or any other health care related license preferred.

    12 days ago from Kaiser Permanente


    Health Plan of San Mateo - San Mateo, CA

    a managed care health plan, seeks a full time Utilization Review Nurse (Grievance and Appeals) to be responsible for ... Health Services Utilization Review Manager. Primary duties: Review each grievance description received to determine...

    21 days ago from

  • Workers Compensation Claims Examiner

    Dart Container - Mason, MI

    standards. * Coordinate appropriate referral of claims for nurse case management services, transportation, translation ... claims, PIP claims, or other disability related claims * At least 2 years applying basic medical terminology...

    4 days ago from Dart Container

  • Utilization Review Nurse - Full Time - Utilization Management

    Alaska Native Tribal Health Consortium - Anchorage, AK

    Utilization Review Nurse - Full Time - Utilization Management Tracking Code 20140704 Job Description JOB SUMMARY Under ... review information in computer. Communicates results to claims adjusters. Enters billing information for services.

    30+ days ago from Professional Diversity Network

  • Staff Nurse (Revenue Utilization Review)

    U.S. Department of Veterans Affairs - Chicago, IL

    RUR (Registered Utilization Review) Nurse responsibilities include: *Performance of clinical review activities together ... evidence of dependability and reliability. VA Nurse Qualifications: Nurse I Level I - An Associate Degree (ADN)...

    1 day ago from U.S. Department of Veterans Affairs

  • Concurrent Review Nurse

    MVP Health Care - Rochester, NY

    medical appropriateness and level of care assignment. May review individual claims requiring clinical interpretation and judgment. Implements the operational functions of the MVP Utilization Management program as assigned. Travels to...

    1 day ago from RegionalHelpWanted

  • Medical Director, Claims Centralized Operations

    Geina O'malley Company - Spokane, WA

    Claims Centralized Operation Team. TThe Medical Director, Claims Centralized Operations will be a Subject Matter ... Review Duties will include but are not limited to: medical claims payment determinations for provider disputes, liaison...

    30+ days ago from The Ladders

  • Utilization Review Coordinator

    Nurse Management - Portland, OR

    management activities ensuring regulatory compliance. The Nurse Case Manager organizes medical management programs ... The Utilization Review Manager / Case Manager is responsible for facilitating patient care objectives, discharge patient...

    1 day ago from

  • Medical Dir-Claims/Recovery Centralized Operations

    Managed Care Company - Spokane, WA

    denial process. • Reviews cases with concurrent review nurses. • Provides medical expertise for care management • ... Preferred Education: Board Certified (primary care preferred) Preferred Experience: • Peer Review, medical policy/proced...

    30+ days ago from IvyExec

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