- Molina Healthcare (NE)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring ... clinical/ medical reviews of retrospective medical claim reviews, medical claims and...nursing experience, including at least 1 year of utilization review , medical claims review… more
- Zurich NA (Schaumburg, IL)
- Medical Bill Review Senior Nurse...and resolve issues by working with corporate law, Technical Claims and other, as necessary. + Prepare, attend and ... 127127 Zurich Insurance is currently looking for a ** Medical Bill Review Senior Nurse ** to work from our Schaumburg, IL office. With limited direction,… more
- The County of Los Angeles (Los Angeles, CA)
- …REQUIREMENTS: OPTION I:One year of experience performing the duties of a Utilization Review Nurse * or Medical Service Coordinator, CCS.** -OR- OPTION ... UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333)...needed, and to make recommendations on potential areas for medical care evaluation studies. + Attends Utilization Review… more
- Travelers Insurance Company (St. Paul, MN)
- …case resolution. + Review , approve and issue accurate and timely indemnity, medical and expense payments for lifetime/long-term claims . + Determine Value of ... 2 **What Is the Opportunity?** Under moderate supervision, manage Workers' Compensation Claims with: Stable Lifetime Indemnity and/or Medical Benefits where the… more
- Baylor Scott & White Health (Dallas, TX)
- …wages for payroll and for all approvals of medical bills per claim file.Pay and process claims within designated authority levelPerforms other position ... of the Safe Choice Claims Manager the Claims Adjuster is responsible for the review ,...reserve requirements, identify subrogation potential, maintain diaryReview and evaluate medical and loss wages, conduct thorough investigation of the… more
- Insight Global (Brookfield, WI)
- …the product across claims operations. * Provide expert guidance on medical management, litigation management, and complex claim handling strategies. * ... implementation for our clients. We are seeking a seasoned claims professional to serve as the claim 's...knowledge of medical cost containment strategies (bill review , utilization review , provider networks, nurse… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …software for financial care activities including eligibility verifications, pre-authorizations, medical necessity, review /updating of patient accounts, etc. * ... We are currently seeking a*RCM Representative Senior*to join our Third-Party Claims -HB&PB team. This full-time role will primarily work remotely (Days, M-… more
- Morley (CA)
- …case details? If so, this role could be a perfect fit for you! As a Legal Claims Analyst at Morley, you'll play a key role in managing small automotive claims ... to support the client's defense strategies, including lemon law claims + Serve as the "Person Most Knowledgeable" (PMK)...the time + Work in partnership with the California review team (located in Michigan), evaluating vehicle buyback requests… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical ...REQUIRED: A current license to practice as a Registered Nurse issued by the California Board of Registered Nursing.… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- … medical treatment facility, in rehabilitative or occupational nursing or providing medical review of insurance claims . MINIMUM QUALIFICATIONS - ... Utilization Review Nurse (40 Hour) Office/On-site Recruitment...third-party administrator files to oversee contractor handling; + May review medical records of various health care… more