• Medical Claim Review Nurse

    Molina Healthcare (WI)
    …state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure ... **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity...our Appeals and Grievances department. We are seeking a Registered Nurse with previous claims and appeals… more
    Molina Healthcare (04/25/25)
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  • Flight Registered Nurse ( RN

    Vighter Medical Group (Killeen, TX)
    Flight Registered Nurse ( RN ), Killeen, TX (PT)...to their countries of origin. The RN will review medical records to determine if ... - Killeen, TX Position Type Full Time Education Level Registered Nurse ( RN ) Travel Percentage...medical provider (ie, a physician, physician assistant, or nurse practitioner). + Medication administration procedure must assure that… more
    Vighter Medical Group (03/04/25)
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  • Licensed Practical Nurse (LPN)…

    The Arora Group (Bethesda, MD)
    …guidelines. + The Contractor shall frequently collaborate with managers of the UBO, Utilization Review Registered Nurse ( RN ) and pre-certification clerk. ... Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed...be required to stand, bend and reach from open medical record shelving. + Licensure: Current, full,… more
    The Arora Group (02/20/25)
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  • Utilization Review Services RN PRN

    HCA Healthcare (Nashville, TN)
    …geographical market and productivity. **What you will do in this role:** + Conduct medical record review , validate admission status order, conduct a ... and mitigation of concurrent denials. This involves assessing the medical record for appropriateness and level of...+ 1 - 3 years of relevant case management/utilization review experience preferred + Registered Nurse more
    HCA Healthcare (05/07/25)
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  • Flight Registered Nurse ( RN

    Vighter Medical Group (Detroit, MI)
    Flight Registered Nurse ( RN ), Youngstown, OH Job...to their countries of origin. The RN will review medical records to determine if ... - York, PA Position Type Full Time Education Level Registered Nurse ( RN ) Travel Percentage...correctional health environment + Assumes responsibility as the sole medical provider of care for Federal detainees with stable,… more
    Vighter Medical Group (05/03/25)
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  • Flight Registered Nurse ( RN

    Vighter Medical Group (Alexandria, LA)
    Flight Registered Nurse ( RN ) - Alexandria, LA...to their countries of origin. The RN will review medical records to determine if ... Job Location Alexandria, LA - Alexandria, LA Education Level Registered Nurse ( RN ) Travel Percentage...correctional health environment + Assumes responsibility as the sole medical provider of care for Federal detainees with stable,… more
    Vighter Medical Group (03/29/25)
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  • RN Registered Nurse

    Henry Ford Health System (Grand Blanc, MI)
    …treatments, medications, and tests ordered are expeditiously carried out and documented. - Review patient medical record /reports and confers with physician ... - Orientation Self-Evaluation: (C) Competent (NT) Needs Training or Review . - Standards of Performance: - Seven Domains of...must possess current Michigan licensure to practice as a registered nurse ( RN ). - Essential… more
    Henry Ford Health System (03/14/25)
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  • RN Registered Nurse

    Henry Ford Health System (Grand Blanc, MI)
    Registered Nurse - Medical ...tests ordered are expeditiously carried out and documented. + Review patient medical record /reports and ... will be considered the official job description. Education/Experience Requirements + Licensed Registered Nurse credentialed from the Michigan Board of Nursing… more
    Henry Ford Health System (05/08/25)
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  • Clinical Review Nurse I (US)

    Elevance Health (Indianapolis, IN)
    **Clinical Review Nurse I - Medicare Part B** National Government Services is a proud member of Elevance Health's family of brands. We administer government ... policies and apply criteria effectively to make informed medical review decisions, while also communicating those...medical coding is a plus. + Part B Nurse Claims is strongly preferred. + Experience in surgical… more
    Elevance Health (05/03/25)
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  • Registered Nurse ( RN )

    Helio Health Inc. (Gloversville, NY)
    …healthcare issues. In order to support our mission, Helio Health is seeking a Registered Nurse ( RN )to work on aFull-Timebasis for ourFulton Co Comprehensive ... Outpatient ProgramProgram. The Registered Nurse ( RN ) will provide...for medical services. + Develop, recommend, and review medical policies and procedures for all… more
    Helio Health Inc. (05/01/25)
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