- APN Consulting, Inc (TX)
- …FTE with a positive work record.Summary:This position works under the supervision of the Medical Claims Review Nurse and is cross-trained to work in a ... variety of areas and functions, including appeals, claims analytics, DRG Validation claims repricing, and outpatient payment integrity audit concepts.Knowledge… more
- US Tech Solutions, Inc. (Columbia, SC)
- …and utilization practices. May provide any of the following in support of medical claims review and utilization review practices: Performs medical claim ... Job Title: Licensed Practical Nurse Location: Columbia SC 29229 Duration: 3+ Months...medical necessity guidelines. Utilizes allocated resources to back up review determination. Reviews interdepartmental requests and medical information in… more
- Mindlance (Columbia, SC)
- …Coordinator Job Location: Columbia, SC Top 3/5 Skills: . RN / Registered Nurse License . Chronic condition care . Case Management Job Responsibilities Reviews and ... or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to… more
- A-Line Staffing Solutions (Tampa, FL)
- …Management, Certified Case Manager, Medical Coding, BSN, Medical Management, Utilization Review , Utilization Management, Registered Nurse , MCO, RN, HMO, ... Concurrent Review , Retrospective Review , Managed Care, Medical Claims , Appeals, Mail...Review , Retrospective Review , Managed Care, Medical Claims , Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior… more
- A-Line Staffing Solutions (Irving, TX)
- …control. Tasks are subject to sequential or final verification by a registered nurse or a registered pharmacist. Supports and adheres to the US Oncology Compliance ... regulation, and only at the direction of the supervising pharmacist after their review of the prescription in accordance with The Company policy and procedure.… more
- City of New York (New York, NY)
- …The Division of Liens and Recovery Casualty Program places liens and assert claims against the personal injury lawsuit settlements of past or present recipients of ... of Nurses to function as a Complex Medical Case Reviewer , who will: - Conduct medical reviews and analyses..., who will: - Conduct medical reviews and analyses claims to calculate injury related Medicaid liens pursuant to… more
- Access Dubuque (Dubuque, IA)
- …reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract ... authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated ...Representative - Call Center Grand River Medical Group Biologic Nurse (RN/LPN) Grand River Medical Group Account Manager Kunkel… more
- Lincoln Financial Group (Lincoln, NE)
- …a Glance** We are excited to bring on a highly motivated Long-Term Disability (LTD) Claims Specialist to our claims organization. As an LTD Claims ... Specialist, you will manage a workload of Long-Term Disability claims independently in accordance with established procedures and guidelines. You will be responsible… more
- Lincoln Financial Group (Juneau, AK)
- …at a Glance** We are excited to bring on highly motivated Short Term Disability Claims Specialists to staff our ever-growing claims organization. As a Short Term ... about a Day in the Life (https://www.youtube.com/watch?v=vbSYiXOPSII&feature=youtu.be) of a Claims Specialist at Lincoln Financial Group! **What you'll be doing**… more
- Lincoln Financial Group (Nashville, TN)
- …Role at a Glance** We are excited to bring on a highly motivated **Group Claims Specialist** to support our ever-growing claims organization in a work from home ... to support our west coast employer groups. _Background details_ As a Group Claims Specialist, you will support our Short Term Disability or Integrated Absence teams.… more
