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Claims Review Nurse jobs

Viewing 1 - 10 of 229 jobs

  • Clinical Claim Review RN - Telecommute

    UnitedHealth Group - Maryland

    areas: Primary Responsibilities: * Reviews post service claims for clinical eligibility for coverage as prescribed ... Assets: * Utilization management experience * Chart review experience * Appeals experience * Milliman guidelines...

    23 hours ago from UnitedHealth Group

  • Clinical Claim Review RN - Telecommuting

    Department of Workforce Services - Salt Lake City, UT

    * Preferred Qualifications:* * Experience in utilization review,case management,clinical claims review preferred * ... guidelines preferred * Nursing experience in utilization review,case management,clinical claims review preferred *...

    30+ days ago from Department of Workforce Services

  • Clinical Claims Review LPN - US Telecommute

    UnitedHealth Group - Hartford, CT

    work.(sm) Primary Responsibilities: * Performing triage of claims based upon the readmission review criteria to include ... * Geriatric or Medicare experience. * Claims Review. * Medical Reimbursement. Careers with...

    1 day ago from UnitedHealth Group

  • UM/Concurrent Review Nurse

    Alegent Creighton - 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...

    4 days ago from Alegent Creighton

  • Nurse RN Medical Management I/II/Sr - Utilization Review - Telecommute Option - 93464

    Anthem - Woodland Hills, CA

    *Job Title: Nurse Medical Management I / II / Sr.* *This position is a telephonic position in an office environment with ... EOE.M/F/Disability/Veteran./ **Job** *Medical* **Title:** *Nurse RN Medical Management I/II/Sr - Utilization Review - Te...

    4 days ago from Anthem

  • Claim DRG Readmission Review RN - Telecommute opportunity

    UnitedHealth Group - Las Vegas, NV

    for medical necessity. * Assist with other Medical Claims review questions, as needed. * Seeks input from ... review, Las Vegas, NV, Nevada, United Health Group, concurrent review, medical claim review, telecommute, work from...

    14 days ago from UnitedHealth Group

  • Care Manager II-Post Service Review- TELECOMMUTING OPTION! (CA: Woodland Hills)

    Health Net - Woodland Hills, CA

    service requests, medical necessity appeals or claims review requests including high dollar claims after the ... when appropriate. Conducts retrospective review of service requests, medical necessity appeals or claims...

    26 days ago from Health Net

  • Pediatric Surgery - Medical Peer Reviewer

    Allmed Healthcare Management - Remote, OR

    Healthcare Management helps healthcare payers to reduce claims costs, while ensuring consistent patient coverage. In ... is an Equal Opportunity Employer. *Pediatric, Pediatrics, Surgery, Surgeon, Medical Review Physician, Work From...

    30+ days ago from AllMed Healthcare Management, Inc.

  • Outside Property Claims Specialist - Commercial Lines

    CNA Financial - Chicago, IL

    commercial property claims. This unit handles property claims up to %24250,000. Candidates with only personal lines ... Identifies claims with third party recovery potential and coordinates with subrogation/salvage unit...

    30+ days ago from CNA Financial Corporation

  • Clinical Review Auditor

    Humana - Louisville, KY

    Role: Clinical Review Auditor *Assignment:*Provider Network *Location:*Work at Home Healthcare isn’t just about health ... Network Operations* **Title:** *Clinical Review Auditor* **Location:** *KY-Louisville* **Requisition ID:**...

    14 days ago from Humana

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