Medical Claim Review Nurse jobs

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Utilization Management Specialist
L.A. Care Health Plan 9 reviews - Los Angeles, CA
Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent post-service and retrospective claims medical review....
Sponsored by L.A. Care Health Plan - 30+ days ago
Workers Compensation Claims Examiner
Dart Container 94 reviews - Mason, MI
At least 2 years of experience analyzing and managing lower to mid level workers compensation claims, PIP claims, or other disability related claims....
Sponsored by Dart Container - 11 days ago
Sr. Clinical RN Review Specialist, Physical Medicine
Healthways - Sterling, VA
Utilization review, regulation, accreditation, medical office billing/coding or clinical/administrative nursing....
Easily apply
Sponsored by Healthways - 26 days ago

RN Nurse Review Consultant (Remote)

Health Care Excel, Inc. - Indiana
Candidates with a passion for growth, development, and innovation will find a career at Health Care Excel a very rewarding experience.The RN Nurse Review...
8 days ago - save job - email - more...

Medical Review RN - Medicare

HP 3,119 reviews - Camp Hill, PA - +1 location
Medical Review RN - Medicare. Three to five years of experience in the medical, surgical or rehabilitative/therapy field as a Registered Nurse or other...
16 days ago - save job - email - more...

Disability Clinical Consultant

Aetna 396 reviews - Portland, OR
Completes medical reviews considering specific contractual provisions, as applicable. Nursing/Registered Nurse is required....
5 days ago - save job - email - more...

Preservice Review RN Optum Medical Network - Las Vegas, NV

UnitedHealth Group 1,660 reviews - Las Vegas, NV
RN Prior Authorizations, Preservice Review, Managed Care, Utilization Review, Utilization Management, Critical Care, Acute Care, Medical Surgical, Milliman, ICD...
6 days ago - save job - email - more...

Medical Review QA RN

NCI Information Systems, Inc. 107 reviews - Grove City, OH - +1 location
You will support the Medical Review management staff and the Lead Claims Review Analysts by providing education and identifying training opportunities during...
5 days ago - save job - email - more...

MEDICAL SERVICES REVIEWING NURSE II

State of Maryland 95 reviews - Baltimore, MD
$45,938 - $73,541 a year
Utilizing specialized nursing knowledge and extensive experience in Current Procedural Terminology coding (CPT), Internal Classification of Disease coding (ICD...
5 days ago - save job - email - more...

(RN) Integrated Personal Health Team- Nurse Case Manager

CIGNA 761 reviews - Eden Prairie, MN
(RN) Integrated Personal Health Team- Nurse Case Manager. Delivers utilization review services when member is in active case management as appropriate....
12 days ago - save job - email - more...

Utilization Review Nurse - Claim Nurse Review (WAH only)

CIGNA 761 reviews - United States
Utilization Review Nurse - Claim Nurse Review (WAH only). The Utilization Review Nurse (RN) conducting retrospective clinical claim reviews and clinical appeals...
9 days ago - save job - email - more...

Registered Nurse (RN) - Case Manager

Aetna 396 reviews - Louisville, KY 40223 - +4 locations
Functional - Nursing/Clinical claim review and coding/1-3 Years. Reviews annual review data file of Lock-in members who meet criteria for the annual review...
5 days ago - save job - email - more...

Nurse / RN Medical Claim Review Specialist (Denton, Texas) (...

CIGNA 761 reviews - Bedford, TX
Nurse / RN Medical Claim Review Specialist (Denton, Texas) (Ft. Appeals & Complaints Nurse:. Med Mgt--Med Review & Appeals....
12 days ago - save job - email - more...
Performance Improvement Clinical Specialist I - Telework
Partnership HealthPlan of California 9 reviews - Fairfield, CA
Performs Facility Site Reviews (resources and medical record review) per contractual requirements. Performs medical record reviews for all Quality Improvement...
Sponsored by Partnership HealthPlan of California - 30+ days ago
We're hiring Nurse Case Managers
Regal Medical Group - Covina, CA
Manager of Nurse Case Management. Regal Medical Group and our physician network are committed to delivering high-quality medical care and improving patient...
Easily apply
Sponsored by Regal Medical Group - 30+ days ago

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Company with Medical Claim Review Nurse jobs
9 reviews
L.A. Care is a leader in developing new programs through innovative partnerships designed to provide health coverage.