Claim Reviewer jobs

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PARD Manager
Florida Blue - 312 reviews - Dallas, TX 75270
Establishes reimbursement for services, ensures that assigned staff updates interim rates and other payment factors, ensures that all changes are entered into...
Premium Audit Reviewer
Alaska National Insurance Company - 14 reviews - Anchorage, AK 99502
$32,000 a year
We offer career paths in Underwriting, Claims, Loss Control, Audit, Assigned Risk, Information Technology, Accounting and Administration....
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RN - HCC Chart Reviewer
Davita - 2,327 reviews - Malvern, PA 19355
Essential functions of the Chart Reviewer role will include:. The Chart Reviewer (CR) is responsible for performing thorough clinical reviews of outpatient,...

Health Insurance Payment Analyst I

Chickasaw Nation Industries - 25 reviews - Rockville, MD 20850
Experience working as a data analyst, auditor, quality control / assurance reviewer, or with Medicaid or other health insurance claims is preferred....

OPM Case Reviewer: Level 1

CSRA - 237 reviews - Remote
Conducts analysis of current claims trends and investigates means to improve claim processes. May review various types of claims such as property and casualty...

Medical Writer - [US, Remote]

ACCELOVANCE - 10 reviews - Rockville, MD
Researches and prepares protocols for food and dietary supplements for health claims, qualified health claims and structure-function claims documents, and...

Claims Reviewer

TriWest Healthcare Alliance - 307 reviews - Phoenix, AZ
Provides clinical and coding-related information to medical director, providers, peer reviewers, Claims Administration, Program Integrity, Quality Management...

Secondary Reviewer Physician

Universal Consulting Services - 14 reviews - Fairfax, VA 22033
Provide recommendations by preparing a Standard Naval letter that either supports the initial denial or reverses the TSGLI claim utilizing a computer based...

Healthcare Claims Reviewer

DXC Technology - 996 reviews - Madison, WI
Approves any remedial or recoupment actions associated with escalated claims. Provides expertise to investigate and adjudicate claim characteristics that do not...

Student Cooperative (Paid) - CMAFO

U.S. Federal Government - 403 reviews - Atlanta, GA
$15.75 - $20.60 an hour
If your application is referred to the review official, the reviewer will compare your self-assessment questionnaire responses to your resume and supporting...

Chart Reviewer - RN or PA

Tandigm Health LLC - West Conshohocken, PA
ACCURATE CODING & EDUCATION CHART REVIEWER. The ACE Chart Reviewer will be responsible for educating others on appropriate documentation based on chart review...

Estimate Reviewer III

Crawford & Company - 251 reviews - Jacksonville, FL 32256   +3 locations
The Crawford Solution® offers comprehensive, integrated claims services, business process outsourcing and consulting services for major product lines including...

Clinical Reviewer RN

Cigna - 2,680 reviews - Nashville, TN
Understand and investigate billing issues, claims and other plan benefit information. The Appeals Reviewer reports to the Supervisor/Manager of Appeals and will...
QA Nurse Reviewer
Medical Consultants Network - 7 reviews - Seattle, WA
$40,000 - $45,000 a year
Since 1985 Medical Consultants Network (MCN) has been a premier provider of medical judgment services addressing injury and disability claims for thousands of...
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Clinical Pharmacist Reviewer
Magellan Health - 442 reviews - Orlando, FL 32812
Title Clinical Pharmacist Reviewer. Regularly reviews and monitors prescription claims data and prescribing practices identified as outliers by internal and/or...