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Claims Review Nurse jobs

Viewing 1 - 10 of 10,649 jobs

  • Medical Claim Review Nurse/Medical Advisor

    CSRA - Hanover, MD

    The Claims Review Nurse/Medical Advisor will be responsible for reviewing medical claims and supporting documents to det ... and services to be covered under the Program. The Claims Review Nurse/Medical Advisor will work with...

    14 days ago from CSRA

  • Utilization Review RN

    Dignity Health Medical Foundation - Rancho Cordova, CA

    Description JOB ID: 1600000167 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...

    5 days ago from Dignity Health Medical Foundation

  • RN - Appeals Specialist

    Multicare - Tacoma, WA

    to: prospective and retrospective Medicaid and Medicare review, Government program denial review, managed care ... in Case Management (CCM), Professional Utilization Review (CPUR), Professional Utilization Review (CPUM) or...

    17 days ago from Multicare

  • Health Center Supervisor, RN

    Premise Health - Camden, NJ

    b.Liaison for workman’s compensation claims with client third party administrator c.Liaison for disability ... f.Powered industrial equipment exams g.Initial review of OSHA respirator questionnaires h.Coordinate Occupational,...

    30+ days ago from Premise Health

  • Claims- Care Manager

    Long Term Care Group - Eden Prairie, MN

    5. Monitor daily, weekly and monthly reports to ensure claims are handled timely and appropriately. 6. Attend case ... conferences, internally and with the client, to present claims recommendations. 7. Meet quality and production...

    8 days ago from CareerBuilder

  • Workers' Compensation Claims Adjuster

    National Interstate Insurance Co - Fenton, MO

    Refer all medical bills to vendors for bill review, audits and/or peer reviews, and ensure all bills are paid within the ... for claims reviews and audits as required. Review and remain updated on all current laws and necessary forms in...

    30+ days ago from Glass Door

  • Registered Nurse - Case Manager/Utilization Review/HEDIS

    Maxim Facility Nursing - Jacksonville, FL

    • Perform chart review/audits monthly or as needed. • Participate in monthly case conferences by providing information pertinent to patient’s ... • Follow State/Country mandated guidelines for the nurse case management programs...

    18 days ago from Maxim Facility Nursing

  • Licensed Practical Nurse/Licensed Vocational Nurse (LPN/LVN)

    Premise Health - San Francisco, CA

    We have an opening for a Full-time Licensed Vocational Nurse (LVN) to work as our Care Coordinator at our employer health center located in San Francisco, CA! Premise Health is a leading worksite health and patient engagement company...

    18 days ago from Premise Health

  • Medical Malpractice Investigator

    Fojp Service - New York City, NY

    meetings, risk management education programs and claim review activities. The Professional Liability Investigator ... adverse patient incidents; and provides claims administration and litigation management services. Through...

    12 days ago from Nurse.com

  • Claims Examiner II - Position Closes 3/2/16 at 5:00 p.m.

    Montana State Fund - Helena, MT

    expenditures on claims. 65% Identifies and performs claims management activities to mitigate negative trending ... in case resolution. Includes, but not limited to, peer review, legal resources, nurse case management, vocational...

    22 hours ago from Glass Door