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Claims Review Nurse jobs

Viewing 51 - 60 of 9,551 jobs

  • Registered Nurse-Review Analyst

    Iconma - Detroit, MI

    range of industries. Job Description: Registered Nurse-Review Analyst Location: Detroit, MI Duration: 10 months ... Enrollment & Claims Responsible for the approval or rejection of claims, admissions approvals, telephone triage, and/or...

    2 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...

    8 days ago from ZipRecruiter

  • Utilization Review RN/LPN Coordinator

    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...

    8 days ago from ZipRecruiter

  • 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...

    16 days ago from ZipRecruiter

  • Utilization Review Registered Nurse (RN) / HMO

    A-line Staffing Solutions - Detroit, MI

    Job Summary of the Utilization Review Registered Nurse (RN) / HMO: Perform timely initial clinical review as ... for review purposes. Qualifications of the Utilization Review Registered Nurse (RN) / HMO: Active RN MI license in...

    18 days ago from ZipRecruiter

  • Coding & Documentation Review Specialist

    National Recruiting Group - Melville, NY

    Position Summary: Certified coder responsible for the review of provider documentation and coding. Supply the ... that the coding is appropriate prior to releasing the claims to be billed. Duties/Responsibilities: Assists...

    3 days ago from ZipRecruiter

  • DRG Reviewer

    Nychsro/medreview - New York City, NY

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

    7 days ago from ZipRecruiter

  • Clinical Manager of Medical Review -

    E-health - Milwaukee, WI

    Job Description: Mgr NGS Medical Mgmt: Manages medical review nursing staff and grievance and appeals units for National ... appropriateness of care and accurate claims payment. • Conducts pre-certification, and appropriateness of...

    23 days ago from ZipRecruiter

  • Claims Analyst

    AP Healthcare - Boston, MA

    and other payers through phone calls, questionnaires, claims, provider inquiries, and other methods as required. ... customers as needed. Review, research and process all COB claims for members with other insurance, including...

    16 days ago from ZipRecruiter

  • Clinical Claims Review Nurse, RN - Telecommute Nationwide

    UnitedHealth Group - San Antonio, TX

    reviews of physician and outpatient hospital claims, following Medicare guidelines and UnitedHealthcare ... Clinical claims review, RN, Nurse, Registered Nurse, claims review, claims, utilization management, clinical,...

    15 hours ago from UnitedHealth Group

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