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Nurse Reviewer
Mercy - 139 reviews - Springfield, MO
Conduct medical record reviews using EPIC, other electronic medical record applications or paper records....
Clinical/ Denial Auditor: RN or LPN (Full Time)
Medical chart auditing experience. Experience as a Nurse Auditor with a hospital or audit firm. Minimum of Associates Degree in Nursing or Health Information...
Quality Improvement Analyst/RN M-F days
Mercy - 139 reviews - Springfield, MO
Licensed Registered Nurse in the State of Missouri. Ability to perform chart reviews for Quality and Risk Management information....

Medicare Medical Review RN

NCI Information Systems, Inc. - Grove City, OH  +5 locations
As the Medicare Medical Review RN ( Medical Reviewer ), you will be responsible for conducting clinical reviews of medical records during the course of fraud...

Clinical Investigator- Nurse Coder (Fraud Sr. Specialist)

Cigna - 1,648 reviews - United States
Analyze and interpret patient medical records pertaining to FWA investigations. Abstracts CPT, HCPCS, ICD-9/ICD-10, Revenue Codes, and DRG from medical records....

Clinical Nurse Investigator

Humana - 1,877 reviews - Tampa, FL
Ability to review medical records adhering. Clinical expertise when performing medical record reviews. The medical review component of fraud investigations and...

Nurse Medical Management I / II / Sr. - Glendale, CA - 11977...

Anthem, Inc. - 1,592 reviews - Glendale, CA 91205
RN Nurse Medical Management I / II / Sr. Experience with Electronic medical records is a plus. Medical surgical or....

Medical Claim Review Nurse (not remote)

Molina Healthcare - 231 reviews - Spokane, WA
Evaluates medical records and/or medical notes providing clinical expertise on coding accuracy. Active, Registered Nurse....

DRG Nurse Auditor (remote, work from home)

Carewise Health, Inc - Remote
Verifies that all complicating conditions are appropriate and documented in medical records. Medical Bill Review ensures that health plans and self-insured...

Utilization Management Specialist

Lutheran Hospital - 91 reviews - Cleveland, OH 44113 (Tremont area)
Basic knowledge of medical records coding standards. Requires constant attention to detail, reading of medical records, and meeting deadlines....

Medical Investigator I/II

Excellus BlueCross BlueShield - 21 reviews - Rochester, NY
By the Credentials Committee based on the clinical review of providers’ medical records,. The Medical Investigator conducts more complex clinical reviews....


Bon Secours Health System - 317 reviews - Baltimore, MD
Work requires knowledge of medical terminology, anatomy, diagnoses, operational procedures, basic medical....

Quality Performance Specialist Clinical RN

AmeriHealth Caritas - 101 reviews - Southfield, MI
In addition, responsibilities also include supporting the annual medical record review activities including HEDIS and, Clinical Practice Guidelines....
Quality Improvement Coordinator, RN - Vascular Services
This includes organizing relevant task forces, review of evidenced based literature/benchmarks, establishment of indicators for monitoring and evaluation of...
RN Clinical Reviewer
Review medical records for various types of medical services for accuracy, completeness and consistency with professional standards and compliance with billing...

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Company with Medical Record Review Nurse jobs
Embark on a health care career of excellence, compassion, and fulfillment with Mercy.