Medical Claim Review Nurse jobs

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Nurse Medical Management I-Texas Telecommute - 95639
WellPoint 459 reviews - Houston, TX
Works with medical directors in interpreting appropriateness of care and accurate claims payment; Consult with clinical reviewers and/or medical directors to...
Sponsored by WellPoint - 3 days ago
Nurse Medical Management I - 88123
WellPoint 459 reviews - Nashville, TN
Works with medical directors in interpreting appropriateness of care and accurate claims payment. Consult with clinical reviewers and/or medical directors to...
Sponsored by WellPoint - 3 days ago

Nurse Attorney/Legal Nurse Consultant

Hanover Insurance 31 reviews - Howell, MI
Nurse Attorney/Legal Nurse Consultant. Provides claims adjusters and attorneys with detailed analysis of medical records and other pertinent medical information...
The Hanover Insurance Group - 1 day ago - save job - block - email - more...

Utilization Review Nurse I - (Cerritos, CA)

WellPoint, Inc 459 reviews - Los Angeles, CA - +1 location
Review of claim edits, pre-noted inpatient admissions or, episodic outpatient therapy such as physical therapy that is not associated with a continuum of care,...
WellPoint - 1 hour ago - save job - block - email - more...

Medical Review Nurse Analyst

Wisconsin Physicians Service Insurance Corporation - Madison, WI
Conduct complex medical reviews of Medicare claims utilizing medical records and billing information. Clinical experience – Acute Hospital, Skilled Nursing...
6 days ago - save job - block - email - more...

Medical Review Nurse

Xerox 2,522 reviews - Ridgeland, MS 39157
Medical Review Nurse*. Must have claims review experience. Reviews patient medical history and identifies possible safety or conflict issues....
Xerox Corporation - 6 days ago - save job - block - email - more...

Medical Claim Reviewer/LVN

Molina Healthcare 106 reviews - Long Beach, CA
Minimum one year Utilization Review and/or Medical. Responsible for retrospective medical claim reviews of rendered inpatient and outpatient health care...
3 days ago - save job - block - email - more...

CLINICAL CLAIMS REVIEWER

Optima Health 8 reviews - Virginia Beach, VA
Review of procedures for post-authorization based on medical necessity, medical and behavioral health standards of care, and benefit determinations;...
3 days ago - save job - block - email - more...

Medical Reviewer III

BlueCross BlueShield of South Carolina 12 reviews - Augusta, GA
Provides support and review of medical claims and utilization practices. Performs medical reviews using clinical/medical information provided by physicians...
16 hours ago - save job - block - email - more...

Revenue Integrity Specialist

Barnabas Health 262 reviews - Oceanport, NJ
Reviews daily claim edit reports and develops a work plan to identify key CDM issues. Demonstrated success performing CDM reviews, CPT/HCPCS coding expertise,...
2 days ago - save job - block - email - more...

Medical Reviewer RN

Blue Cross Blue Shield 1,244 reviews - Albuquerque, NM - +1 location
This position is responsible for ensuring accurate and timely medical review of professional provider claims suspended for medical necessity contract...
HCSC - 11 days ago - save job - block - email - more...

Medical Bill Review Clinical Selection Analyst

Carewise Health 6 reviews - Louisville, KY
Healthcare claim audit experience. Medical Bill Review ensures that health plans and self-insured employers are billed accurately for the care their members...
16 days ago - save job - block - email - more...
Staff Nurse (Revenue Utilization Review)
Department of Veterans Affairs 737 reviews - Washington, DC
Reviews and conducts special eligibility validation reviews including SC, Agent Orange, Combat Vet, etc. The RUR nurse collaborates with clinical staff to...
Sponsored by Nurse.com - 2 days ago
Infection Preventionist/Occupational Health Specialist
Banner Health 317 reviews - Worland, WY
About Washakie Medical Center. With a 50-year tradition of quality caring, Washakie Medical Center in Worland, Wyo....
Sponsored by Banner Health - 7 days ago
Medicare Medical Review RN
NCI Information Systems, Inc. 104 reviews - Nashville, TN
As the Medical Review Nurse ( Medical Reviewer III ), you will primarily be responsible for conducting clinical reviews of medical records during the course of...
Sponsored by NCI Information Systems, Inc. - 7 days ago

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Company with Medical Claim Review Nurse jobs
459 reviews
WellPoint is a health benefits company, an independent licensee of the Blue Cross and Blue Shield Association.