- Zurich NA (Schaumburg, IL)
- Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently looking for a ** Medical Bill Review Senior Nurse ** to work from our ... quickly and completely, provide status updates to ensure customer satisfaction. + Review assigned medical bills, apply technical insights, applying discretion… more
- Elevance Health (Hialeah, FL)
- **HEDIS Medical Records Review Project Nurse ** **Location: Must be located within 50 miles of an Elevance Health PulsePoint office in the state of Florida.** ... employment, unless an accommodation is granted as required by law._ The **HEDIS Medical Records Review Project Nurse ** is responsible for HEDIS medical … more
- New York State Civil Service (New York, NY)
- NY HELP No Agency Attorney General, Office of the Title Legal Nurse | Review Medical Malpractice Claims for NYS (6402) Occupational Category Legal Salary Grade ... Analysts assigned to the Claims Bureau will analyze and review claims containing allegations of medical malpractice;...and be registered to practice as a registered professional nurse or licensed physician in New York state. It… more
- Molina Healthcare (Warren, MI)
- …on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience, ... responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and… more
- Actalent (New Haven, CT)
- …###@actalentservices.com! What You'll Do In this dynamic role, you'll serve as both a Medical Review Nurse and Triage Specialist, helping patients navigate ... Registered Nurse - Join a Mission-Driven Medical ...of the way + Growth Opportunity: Gain experience in medical review , triage, and research functions Ready… 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
- UCLA Health (Los Angeles, CA)
- …for reviewing and evaluating clinical documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical ... Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role...protocols and national clinical guidelines (eg, InterQual, Milliman) in review decisions. + Coordinates escalations to medical … more
- Elevance Health (Houston, TX)
- …states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse ** is responsible for review of the most complex or challenging ... ** Medical Management Nurse ** **Location: Virtual: This...Skills and Experiences:** + ACMP experience is preferred. + Medical Management experience is preferred, + Utilization Review… more
- Elevance Health (Latham, NY)
- …states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse ** is responsible for review of the most complex or challenging ... ** Medical Management Nurse ** **Location: Virtual: This...in multiple states. **Preferred Capabilities, Skills and Experiences:** + Medical Management experience is preferred, + Utilization Review… more
- HCA Healthcare (Nashville, TN)
- …growth, we encourage you to apply for our Trauma Medical Surgical Nurse opening. We promptly review all applications. Highly qualified candidates will be ... **Introduction** Do you have the career opportunities as a(an) Trauma Medical Surgical Nurse you want with your current employer? We have an exciting… more
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