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Claims Review Nurse jobs

Viewing 1 - 10 of 550 jobs

  • Claims Analyst

    Emblemhealth - Melville, NY

    problems with implemented systems logic and organizational claims procedures. Reviews project requirements for the ... expertise in the development and review of requirements, review and assistance with IS unit testing, and transition...

    4 days ago from Money Jobs

  • RN Utilization Review / Care Coordinator

    TRC Staffing Services - Phoenix, AZ

    and is responsible for appropriate and timely resolution of claims requiring clinical review. As a review specialist the ... healthcare experience prior experience in Utilization review, Quality Assurance or health insurance, appeals and...

    8 days ago from CareerBuilder

  • RN Clinical Reviewer

    Medrisk - Norristown, PA

    care plan and radiology services.6. Review all initial review requests submitted and provide documentation to ... claims. 7. Support non-clinical administrative personnel, Nurse Case Managers and all MedRisk personnel when...

    14 days ago from CareerBuilder

  • 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...

    30+ days ago from UnitedHealth Group

  • Staff Nurse (Utilization Review)

    Federal Government Jobs - Lebanon, PA

    instructions carefully) Job Title:Staff Nurse (Utilization Review) Department:Department Of Veterans Affairs ... opportunity available for an experienced Registered Nurse (Utilization Review) for the Consolidated Patient Accounts...

    4 days ago from afro

  • Utilization Review Nurse

    Medical Audit Consultants - Laguna Hills, CA

    necessity reviews for both commercial and government claims. EDUCATION REQUIREMENTS Must have an active RN ... patient care required with Case Management/Utilization Review knowledge mandatory. SPECIAL KNOWLEDGE, SKILLS AND...

    11 days ago from ZipRecruiter

  • 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...

    30+ days ago from Health Net, Inc.

  • Outside Property Claims Specialist - Commercial Lines

    CNA Financial - Farmington Hills, MI

    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...

    6 days ago from CNA Financial Corporation

  • Outside Property Claims Specialist - Commercial Lines

    Continental Casualty Company - Chicago, IL

    commercial property claims. This unit handles property claims up to $250,000. Candidates with only personal lines ... Identifies claims with third party recovery potential and coordinates with subrogation/salvage unit...

    7 days ago from Continental Casualty Company

  • Supv., Claims

    Emblemhealth Services - Hollywood, FL

    monitoring proper handling and timely processing of Medical claims and prepare daily, weekly, and monthly reports ... years supervisory experience. Strong knowledge of Medical Claims processing, procedures and systems. Knowledge of...

    12 days ago from EmblemHealth Services

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