• Medical Claim Review…

    Molina Healthcare (Austin, TX)
    …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)
    - Related Jobs

  • Physician, Primary Care (Ambulatory Care)…

    Veterans Affairs, Veterans Health Administration (Austin, TX)
    …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... services through an interdisciplinary team that includes the PCP, RN care manager, LVN , clerical associate as well as other clinical services necessary to meet the… more
    Veterans Affairs, Veterans Health Administration (08/27/25)
    - Related Jobs

  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Austin, TX)
    …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)
    - Related Jobs

  • Patient Navigator

    Cardinal Health (Austin, TX)
    …+ Clear knowledge of Medicare (A, B, C, D) + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience is preferred + 1-2 years of ... preferred + Previous social work experience is preferred + LVN is preferred + 2-4 years of Case Management...to Word, Outlook, and preferred Excel capabilities + Previous medical experience is preferred **_Responsibilities_** + Deliver virtual or… more
    Cardinal Health (09/12/25)
    - Related Jobs