Medical Claim Review Nurse jobs

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LTC Claims Intake Nurse
Genworth Financial - Lynchburg, VA
Ability to review and educate the customer on multiple Long Term Care policy types. Communicating with claimants or their representatives when they contact the...
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Claims Nurse Consultant
The Claims Nurse Consultant (CNC) reviews, evaluates, and. With medical review findings. That develop medical review process and procedures....
Sponsored by Guardian Life Insurance Company
Registered Nurse - Workers' Comp Medical Cost Projections
Hoover Rehabilitation Services, Inc. - Mechanicsburg, PA
Is seeking a Registered Nurse to perform medical record review and analysis of treatment recommendations to project future medical claim costs....
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Medical Review Nurse Auditor

Performant Financial Corporation - 4 reviews - San Angelo, TX
Conduct medical chart reviews. The Medical Review Nurse Auditor o bjectively and accurately completes medical record reviews on assigned audits while meeting...

Nurse Medical Reviewer - Office or Home-based

Quality Health Strategies - Easton, MD 21601
The Nurse Medical Reviewer is a mid-level professional position that performs medical record and claims review for Medicaid, and/or other claims data in order...

Nurse First Response / Utilization Review Nurse (Part-Time,...

Xerox - 6,730 reviews - Atlanta, GA 30309 (Midtown area)
Nurse First Response / Utilization Review Nurse (Part-Time, Remote)*. Assist with Triage, Utilization Review and possibly Nurse Case Management....

Nurse Medical Mgmt I/II/Sr - Richmond, VA - 117066

Anthem, Inc. - 1,538 reviews - Richmond, VA 23218 (City Center area)
Nurse Medical Management I. Nurse Medical Management I/II/Sr. Works with medical directors in interpreting appropriateness of care and accurate claims payment....

Medical Review Nurse

Adventist Health System Corporate Office- Adventis... - Port Charlotte, FL
We are currently seeking qualified candidates for a Medical Review Nurse position that will be based in our Home Health department....

Nurse Disability Consultant

Lincoln Financial - 323 reviews - Atlanta, GA
Supports Senior Nurse Disability Consultants in providing training and mentoring to new claims staff, peers and/or other claim professionals....

SNF Clinical Reviewer

Proactive Management Consulting Evansville, IN - 11 reviews - Owensboro, KY
Consults with clients to review medical records prepared in response to active medical review by Medicare and other insurers/payers....
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Review Analyst (Inpatient)

BlueCross BlueShield of Tennessee - 3,049 reviews - Chattanooga, TN
Performs prospective and retrospective medical necessity reviews. This position is accountable for the comprehensive review of prospective services and referred...

Review Analyst (Acute Care)

BlueCross BlueShield of Tennessee - 3,049 reviews - Chattanooga, TN
Performs prospective and retrospective medical necessity reviews. This position is accountable for the comprehensive review of prospective services and referred...

Medical Claims Review Nurse

Medix - 48 reviews - Phoenix, AZ
The Medical Claims Review Nurse provides medical claim review techniques to all claim types as determined by the Health Plan....
RN Clinical Reviewer
Minimum 3 years of clinical review experience, Utilization Management review experience, or health care claims auditing experience....
Sponsored
RN Case Manager
ABCBS - 17 reviews - Little Rock, AR
$59,000 a year
Monitor effective claims adjudication based on guidelines for contracted services. Arkansas Registered Nurse with current license and in good standing with...
Sponsored by Arkansas Blue Cross and Blue Shield

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