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Claims Review Nurse jobs

Viewing 31 - 40 of 9,355 jobs

  • Claims Examiner III (14012541)

    Heritage Healthcare - Orange, CA

    claims for non-contracted provider and contracted hospital claims for both Commercial and Senior plans within the ... review purposes or additional information requests until claims are in a final status. Alerts Claims Management of...

    18 days ago from Heritage Healthcare

  • RN-Registered Nurse-Manager Code Edit & Med Nec Review-Managed Care

    Nurse Resolutions - Spokane, WA

    adjudication process thru claim review, medical record review and research. Responsible to review and provide ... to Molina Medical Necessity appeal/disputes for Medicaid claims to ensure efficient and consistent processes with...

    30+ days ago from HealthJobsNationwide.com

  • Claim Manager - HealthCare Programs Segment

    Commercial Property and Casualty Insurance Company - Chicago, IL

    claims resolution skills and knowledge of insurance and claims principles, practices and procedures. 4. Ability to ... claim initiatives. 5. Reviews and manages investigations of claims, liability and damages, and works with senior...

    30+ days ago from IvyExec

  • Utilization Management Nurse Reviewer

    Medical Mutual of Ohio - Cleveland, OH

    Job Description: Utilization Management Nurse Reviewer Reports to: Supervisor Location: Cleveland We strive to create ... non-covered care for medical/surgical and/or psychiatric claims as well as appropriate network utilization. ESSENTIAL...

    30+ days ago from ZipRecruiter

  • Account Claims Representative I - Workers Compensation

    PMA Companies - Mount Laurel, NJ

    Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve ... to clients, including face to face interactions during claims reviews, stewardship meetings and similar...

    5 days ago from CareerRookie.com

  • Utilization Review Nurse

    E-health - Hanover, MD

    in interpreting appropriateness of care and accurate claims payment. -May also manage appeals for services ... benefits, and managed care products. -Prior utilization review experience required. -Prior experience working with...

    18 days ago from ZipRecruiter

  • Claims Examiner II (14012539)

    Heritage Healthcare - Orange, CA

    Monitors and updates inventory reports in order to track claims in inventory and follows-up on all claims suspended ... review purposes or additional information requests until claims are in a final status. Alerts Claims Management of...

    18 days ago from Heritage Healthcare

  • Account Claims Representative II - Workers Compensation

    PMA Companies - Meriden, CT

    Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve ... to clients, including face to face interactions during claims reviews, stewardship meetings and similar...

    30+ days ago from CareerRookie.com

  • Utilization Review Nurse

    Trn - Davidsonville, MD

    Pharmacy, Radiology/Imaging, Nurse/Nurse Management, Nurse Practitioner/Physician Assistant, Hospice/Home ... search. Job Description: Description The Utilization Review RN is responsible for collaborating with healthcare...

    25 days ago from ZipRecruiter

  • Utilization Review RN

    Judge Healthcare - Cleveland, OH

    Precertify/certify and concurrently review and manage all inpatient and observation admissions utilizing InterQual® Leve ... not limited to Emergency Department utilization/claims review. 3. Assess all members receiving inpatient or observation...

    3 days ago from ZipRecruiter

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