- 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
- Premera Blue Cross (Mountlake Terrace, WA)
- … medical policy changes, and coding changes. + Research and interpret medical claims utilization and program participation. Present findings to internal ... Coding Administrator_** will focus on identifying and coordinating appropriate codes to support claim system edits that direct payment of medical services. This… more
- Stanford Health Care (Palo Alto, CA)
- …while identifying instances of overpayments and underpayments. Proficiency in healthcare claims analysis, including the ability to review , interpret, and ... and comprehensive appeal letters to payors after a detailed review of medical records. Ensure compliance with...Spec required within 180 Days + RN - Registered Nurse - State Licensure And/Or Compact State Licensure preferred… more
- Morley (Saginaw, MI)
- …family or school obligations **_What You'll Do_** + **Assist with contract review and management, legal research, policy development and compliance** + Provide ... comprehensive support to our legal and compliance teams + Draft, review and revise legal documents and internal policies + Manage the contract review process,… 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
- 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
- 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
- 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
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- Summary The Revenue Utilization Review (RUR) nurse is under the supervision of the Nurse Manager and ANM. The RUR nurse is an active member of the ... RXs, Care in the Community, DME, and Ambulance. Conducts clinical legal relatedness review for Regional Counsel TORT Claims , No Fault, and Worker's Compensation… more
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