• Medical Claim Review…

    Molina Healthcare (Augusta, GA)
    …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... schedule) Looking for a RN with experience with appeals, claims review , and medical coding....clinical/ medical reviews of retrospective medical claim reviews, medical claims and… more
    Molina Healthcare (09/06/25)
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  • Medical Claim Review LVN/LPN…

    Molina Healthcare (Augusta, GA)
    …clinical nursing experience. Minimum one year Utilization Review and/or Medical Claims Review . **Required License, Certification, Association** Active, ... clinical/ medical reviews of retrospective medical claim reviews, medical claims and...of proactive approaches to improve and standardize overall retrospective claims review . * Ensures core system is… more
    Molina Healthcare (09/12/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Augusta, GA)
    …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge,… more
    Molina Healthcare (08/15/25)
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  • Medical Director

    Molina Healthcare (Augusta, GA)
    …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial… more
    Molina Healthcare (09/12/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Augusta, GA)
    …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial… more
    Molina Healthcare (08/08/25)
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  • Physician, Chief Hematology-Oncology

    Veterans Affairs, Veterans Health Administration (Augusta, GA)
    …information, and the other health services we offer at our Charlie Norwood VA Medical Center in Augusta VHA and CBOC locations. VA offers a comprehensive total ... by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Former EDRP participants ineligible to apply for… more
    Veterans Affairs, Veterans Health Administration (07/12/25)
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