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Claims Review Nurse jobs - Houston, TX

Viewing 1 - 10 of 108 jobs

  • Medical Audit Appeals Spec (RN or RHIA) (127582)

    Texas Children's Hospital - Houston, TX

    process and maintain appropriate follow-up on appealed claims. -Maintain policy & guidelines for Medical Audit and ... guidelines and insurance guidelines for medical necessity review including M&R and Interqual. Medical coding, managed...

    30+ days ago from Texas Children's Hospital

  • Clinical Appeals RN

    UnitedHealth Group - Houston, TX

    and clarification). Primary Responsibilities: * Review medical records and verifying if the requested ... service meets criteria * Review pre and post service claims for clinical eligibility for coverage as prescribed...

    21 days ago from UnitedHealth Group

  • Director of Nursing (RN)

    Team 1 Medical - Houston, TX

    follow-up on issues with the involved parties Review denied claims for medical necessity and will obtain additional documentation as required COMPANY PROFILE: This position is within a premier home health agency. Very well-known and stable...

    13 days ago from

  • Resident Services Director - LPN, LVN or RN

    Elmcroft Senior Living - Houston, TX

    labor use and overtime, and bi-weekly labor reports to review hours used. Managing expenses within given budget ... to their new home. Minimizing Workers Compensation claims by providing inservices in high-risk areas and...

    5 days ago from CareerBuilder

  • On Site Nurse - Telephonic Case Manager (RN or LVN with CCM, CDMS, COHN or eligibility)

    Injury Management Organization - Houston, TX

    treatment care plans with emphasis of early intervention-Review medical records, communicate case needs with ... providers in network environment-Be a liaison between the claims administrator, the employer and the injured employee...

    17 days ago from CareerBuilder

  • LTSS Service Coordnator-RN Clinician

    WellPoint - Houston, TX

    plans. * May also assist in problem solving with providers, claims or service issues. * Directs and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the...

    3 days ago from

  • Nurses - Travelers is Hiring Veterans- Various locations countrywide

    Travelers - Houston, TX

    jurisdictions. For nurses handling Workers Compensation Claims, perform Utilization Review according to established ... EDUCATION/COURSE OF STUDY: Registered Nurse or other qualified health professionals...

    30+ days ago from

  • Medical Review RN

    Quality Health Strategies - Houston, TX

    has an excellent opportunity for an experienced Medical Review RN in its Houston office. The Medical Review RN is a ... professional position that performs medical record and claims review for Medicare, Medicaid, and/or other claims data...

    5 days ago from Quality Health Strategies

  • Claims Manager

    Superior Energy Services - Houston, TX

    claims adjusters, investigators and nurse case managers * Develops and provides or arranges for training ... first party property and other claims * Manages, prepares and submits first party property claims to insurers...

    5 days ago from Superior Energy Services

  • Claims Manager

    Concentric Pipe and Tool - Houston, TX

    all areas of claims and losses. The Claims Manager will also develop and manage rehabilitation and Return to Work ... first party property claims to insurers (includes global property, contractor���s equipment, cargo and hull...

    16 days ago from Concentric Pipe and Tool, LLC

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