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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....
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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...
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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....
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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....

UTILIZATION REVIEW RN

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...
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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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Embark on a health care career of excellence, compassion, and fulfillment with Mercy.