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Claims Review Nurse jobs - New York, NY

Viewing 1 - 10 of 284 jobs

  • Director of Compliance Audits and Appeals (RN)

    Archcare - New York City, NY

    and Medicaid law, regulation, and guidelines; Communicating review results with management; Recommending corrective ... OMIG, and their agents. Responsibilities: Monitor and review SNF clinical documentation to ensure accuracy,...

    30+ days ago from ArchCare

  • Healthcare Physician Practice Consultant / Medical File Review Nurse

    UnitedHealth Group - New York City, NY

    based issues are triaged to the appropriate party for claims analysis and “fix”. Ensure timely resolution of ... nurse, nurse practitioner, RPN, Medical File Review, Medical Coding Careers with UnitedHealthcare. Let's talk...

    30+ days ago from UnitedHealth Group

  • Case Management Manager Nurse

    CPR My Career - Stamford, CT

    Case Management Manager Nurse -100K -20+ years of experience required. -Bachelors Degree required. -Current RN ... -Knowledge of the insurance industry, benefits coverage and claims processing. -Knowledge of case management principals,...

    19 days ago from CPR My Career

  • Register Nurse/ Care Manager

    Independent Living Systems - New York City, NY

    determinations in accordance with Article 49-Utilization Review Ensures collection and review of required documentation ... Reviews clinical documentation, claims/utilization data to ensure members are receiving appropriate care and implement s...

    30+ days ago from

  • Senior Claims Adjuster - Workers Compensation

    PMA Companies - White Plains, NY

    <p>This position will be located in our White Plains NY Office.   </p><p>As a member of our claims tea ... to clients, including face to face interactions during claims reviews, stewardship meetings and similar...

    1 day ago from

  • Registered Nurse (RN)

    Execu|search Group - New York City, NY

    Registered Nurse (RN) Registered Nurse (RN) Location: Manhattan, NY Salary: Experience: 2.0 year(s) Job Type: Temporary ... an integrated case management approach with utilization review and case management activities. Company Description...

    30+ days ago from Advance for Health Care Jobs

  • Utilization Manager- RN- Clinical Review

    Health Care Center - Brooklyn, NY

    Utilization Review. Certification in Utilization Review or Utilization Management is preferred. Must be ... healthcare services to participants. Documents review information in computer. Communicates results to claims...

    7 hours ago from ZipRecruiter

  • Physician Reivew - PRN

    Concentra - New York City, NY

    JOB SUMMARY: Relying on clinical background, reviews health claims providing medical interpretation and decisions about ... claims. -Meets regularly with Concentra Physician Review Medical Director to discuss quality of care and...

    2 days ago from A Mighty River

  • Registered Nurse - PCS Nursing

    U.S. Department of Veterans Affairs - East Orange, NJ

    to qualify), documentation to support Veterans Preference claims, or ICTAP/CTAP documentation (for displaced Federal ... PACKAGES WILL NOT BE ACCEPTED!) * 1-Full-Time * 0610-Nurse * Active * *...

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

  • DRG Reviewer

    Nychsro/medreview - New York City, NY

    Review Organizations (PSROs) for Medicare and Medicaid review. In 2014, NYCHSRO is observing its fortieth (40th) ... to ensure the timely completion of the review Record review decisions and justifications for changes requested or...

    14 days ago from ZipRecruiter

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