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Claims Review Nurse jobs

Viewing 61 - 70 of 9,688 jobs

  • 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...

    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...

    27 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...

    10 days ago from ZipRecruiter


    Cooper University Hospital - Cherry Hill, NJ

    stemming from patient complaint.Assist in overseeing and administering the CDM, making suggestions for improved clinical descriptions and correct mapping. High School Diploma or Equivalent required. Current NJ-RN License (Registered...

    5 days ago from Cooper University Hospital

  • Clincial Claims Review Nurse Advisor

    Humana - Green Bay, WI

    Role: Clinical Claims Review Nurse Advisor Assignment: Clinical Guidance Organization Location: Louisville, KY or Green ... – as a Clinical Claims Review Nurse Advisor you will review medical services for necessity and appropriateness. Humana...

    22 days ago from Humana

  • Registered Nurse / RN Medical Claim Review Specialist Bedford, TEXAS IN OFFICE

    CIGNA - Bedford, TX

    & Complaints Nurse: The position functions as an Appeals Nurse. The Appeals Nurse will perform the clinical review of ... experience with at least three years in utilization review/discharge planning. · Strong clinical knowledge ·...

    3 days ago from Cigna

  • RN, Clinical Claims Review

    Healthcare Partners - Torrance, CA

    RN, Clinical Claims Review Req: 12654 Department: IMCS Claims Schedule: Full Time Shift: Days Hours: Monday 7:00 a.m. to ... seeking aRN, Clinical Claims Review: Responsiblefor review, research and complete retrospective clinical claims...

    8 days ago from Professional Diversity Network

  • Lead Medicare Claims Reviewer (RN)

    Catapult Consultants - Peoria, AZ

    Abilities Required: , , • While performing the duties of this job the employee is regularly required to sit and use hands to finger, handle, or feel while typing at a computer keyboard. • The employee is occasionally required to stand,...

    30+ days ago from Catapult Consultants, LLC

  • Clinical Claim Review RN - Telecommuting

    Department of Workforce Services - Salt Lake City, UT

    * Preferred Qualifications:* * Experience in utilization review,case management,clinical claims review preferred * ... guidelines preferred * Nursing experience in utilization review,case management,clinical claims review preferred *...

    30+ days ago from Department of Workforce Services

  • Clinical Claim Review RN- Maryland

    Health Insurance - Minneapolis, MN

    clinical summations based on Readmission review clinical criteria Verbally present clinical reviews to Field ... policies within claim post service medical review Review system generated denials and provider or customer...

    30+ days ago from ActiveHire

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