Medical Claim Review Nurse jobs

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Utilization Review Coordinator, RN $5000 Sign On Bonus
Visiting Nurse Association of Central New York Inc - Syracuse, NY 13204
Performs continuing review of medical records and supporting documentation for medical necessity where appropriate....
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Medical Review Nurse LPN
Florida Blue - 205 reviews - Jacksonville, FL 32224
Experience with prior authorization or medical review. Previous Medicare or Managed Care experience, including medical review, prior authorization or appeals,...
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Clinical Review Nurse
First Coast Service Options, Inc. - Jacksonville, FL 32224
O May refer for review, or implement, corrective action related to medical review activities. Review and analyze pre and post pay complex health care claims...
Sponsored by Florida Blue

Medical Review Nurse Auditor - Home-based - Sioux Falls

Quality Health Strategies - 9 reviews - Sioux Falls, SD  +5 locations
At least two years claims review experience required. Health Integrity has exciting opportunities for Medical Review Nurse Auditors to join our Cerritos, CA...
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Medicare Medical Review Nurse

NCI Information Systems, Inc. - 2 reviews - Miami, FL  +2 locations
As the Medicare Medical Review Nurse ( Medical Reviewer ), you will primarily responsible for conducting clinical reviews of medical records during the course...

Medical Review Nurse

Performant Financial Corporation - 11 reviews - San Angelo, TX
The Medical Review Nurse performs medical claims audit reviews. Participate in development of Medical Review Guidelines....

Collector (Physician Claims)

Mount Sinai Medical Center - Florida - 30 reviews - Miami Beach, FL
PHYSICIAN CLAIMS COLLECTOR. Use of various payer online claims tools is a plus. Mount Sinai Medical Center is proud to be South Florida's hospital of choice for...

Appeals Nurse LVN or RN

California Health & Wellness - 4 reviews - Rancho Cordova, CA
Review clinical data to determine claim payment based on company policies and National Committee for Quality Assurance (NCQA) guidelines, including overturning...

Nurse Reviewer

CorVel Corporation - 163 reviews - Novi, MI 48375
The Professional Review Nurse must:. The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple...
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Medical Review Nurse

NCI Information Systems, Inc. - 2 reviews - Baton Rouge, LA  +2 locations
As the Medicare Medical Review Nurse ( Medical Reviewer ), you will primarily responsible for conducting clinical reviews of medical records during the course...

Appeals Reviewer RN - Case Management Resource Center

Adventist Health Southern California Network - Glendale, CA
The preparation of this information will be based on accepted industry criteria.Job DutiesPerforms retrospective, post discharge, and post serviced medical...

Medical Claims Review Nurse

All's Well Health Care - 6 reviews - Long Beach, CA
$85,000 a year
The right candidate will have 1-3 years clinical nursing experience, including 1 year Utilization Review and/or Medical Claims Review experience....
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Clinical Review Analyst- BCBS Helena MT

Blue Cross Blue Shield of IL, MT, NM, OK & TX - 11 reviews - Helena, MT  +1 location
This position is responsible for performing clinical retrospective review in accordance with the application of medical necessity criteria using the Medical...
Clinical Review Nurse
Novitas Solutions, Inc. - Mechanicsburg, PA 17050
O May refer for review, or implement, corrective action related to medical review activities. Review and analyze pre and post pay complex health care claims...
Sponsored by Florida Blue
RN Clinical Appeals Analyst
Piedmont Healthcare - 187 reviews - Atlanta, GA 30363
Perform retrospective (post -discharge/ post-service) medical necessity reviews to determine appropriateness of level of care documented and provided using...
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