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Claims Review Nurse jobs

Viewing 61 - 70 of 9,475 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...

    15 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...

    24 days ago from ZipRecruiter

  • 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...

    28 days ago from ZipRecruiter

  • Disability Claims Advocate/Legal

    Personnel People - Providence, RI

    in appealing denied disability benefits. Will obtain and review medical records, and conduct strategic review to ... Legal, Psychological Services, and Veteran or Disability claims management, medical or health insurance claims. Some...

    5 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...

    7 days ago from ZipRecruiter

  • Medical Director, Claims Centralized Operations

    Futuretech Staffing - Spokane, WA

    Expert on Claims and be a Clinical Resource within the Claims Centralized Operation Team. The purpose of this role ... Review Duties will include but are not limited to: medical claims payment determinations for provider disputes, liaison...

    16 days ago from ZipRecruiter

  • Coordinator of UR, Denials, and Claims Management

    E-health - Orlando, FL

    Job Description: Profit experience highly desired; reports to Dir of PFS; experience in hospital admission times, utilization of resources and length of stay, discharge times, etc; works closely with case management; BS min, RN required...

    11 days ago from ZipRecruiter

  • Claims Manager - Workers' Compensation

    Stephenson & Brook - Boston, MA

    multi-dimensional approach to controlling risk. Our team of claims consultants, medical case managers, physicians, ... experience as a claims adjuster, claims specialist, or claims examiner a Plus Salary Range - $60-75K, commensurate...

    29 days ago from ZipRecruiter

  • 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...

    10 days ago from IHispano

  • Medical Claim Reviewer/LVN

    Molina Healthcare - Long Beach, CA

    Minimum one year Utilization Review and/or Medical Claims Review ... State Licensed Vocational Nurse, Licensed Practical Nurse. Preferred Education: Registered Nurse. Bachelor's...

    14 days ago from Molina Healthcare

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