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Claim Reviewer jobs

Quality Assurance Coordinator
Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists....
Desired Experience: Microsoft Word, Medical Terminology
Quality Assurance Reviewer
Previous SC DDSN, Medicaid, Utilization Review, Case Management, Quality Assurance, Claims Auditing or Fraud/Abuse experience required....
Desired Experience: RN, Social Work License, Data Entry, Developmental Disabilities Experience, Auditing
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Utilization Management Rep I/II/III- Norfolk, VA; Las Vegas,...

Norfolk, VA
Refers cases requiring clinical review to a Nurse reviewer. Managing incoming calls or incoming post services claims work....

Relocation Reviewer/Department of Justice Liaison (ODOT18-26...

Salem, OR
$59,340 - $87,636 a year
As a relocation reviewer, this position reviews all types of relocation benefit studies, cost findings, relocation moving claims for personal property, people,...

Nurse Reviewer

Oriskany, NY 13424
In this role you will investigates life insurance claims and makes determination on claims settlement within authorized guidelines....
Desired Experience: RN

Bill Reviewer-ForeSight

Tampa, FL 33607 (Carver City area)
The Bill Reviewer is responsible for appropriately adjudicating workers compensation claims containing implanted devices....
Desired Experience: ICD-10, Microsoft Powerpoint, Customer Service, Microsoft Office, ICD-9, Medical Billing

Process QA Reviewer, Medical Claims

Arlington, TX 76011 (East area)
Knowledge of claim payment and process preferred. We have almost 900,000 healthcare providers under contract, an estimated 68 million consumers accessing our...
Desired Experience: Microsoft Office

Clinical Reviewer

Plano, TX
Works patient facing holds to resolve and get claims out the door. ESSENTIAL DUTIES AND RESPONSIBILITIES:....
Desired Experience: Medical Office Experience, ICD-10, CPT Coding, Excel

Clinical Appeals Reviewer (LHI)

La Crosse, WI 54602
Process daily / weekly claims error files to ensure efficient and expeditious handling of claims. Also includes, the maintenance of the pended claims file and...
Desired Experience: ICD-10, CPT Coding, Microsoft Office, ICD-9, Military Experience

Construction Scheduler Analyst/Reviewer

Whitman, Requardt and Associates, LLP
Virginia +1 location
Develops strategies for negotiating claims. Provides technical support in claims litigation. Construction Scheduler - We are seeking qualified construction...
Desired Experience: Primavera, Microsoft Powerpoint, Project Management, Oracle, Microsoft Office, Construction Experience, Construction Management, Primavera P6

Clinical Appeals Reviewer

Atlanta, GA +1 location
Handle high claims and appeal volume while using internal Claim, UM / UR Behavioral Health, Medical claims / appeal management processes....
Desired Experience: Excel, Windows, Data Entry, Microsoft Word, Medical Terminology

AvMed Clinical Reviewer

Miami, FL
Conducts prospective reviews and reconciliation for targeted claims. Review medical records to determine if specific diagnoses were omitted from claims...
Desired Experience: RN, RHIT, ICD-9, RHIA, Medical Coding Certification, Managed Care
Healthcare Insurance Review Coordinator
Analyzing Reviewer responses for completeness and clarity. Serving as a liaison between clients, reviewers, and providers....
Desired Experience: Microsoft Word, Medical Terminology
Clinical Reviewer (LPN, RN, PA)
Washington & West, LLC
Towson, MD 21204
Review and interpret medical records to appeal denied insurance and Medicare claims for inpatient and outpatient services....
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Medical Records Reviewer Sr
Respond to queries from our clients regarding claim folders. Reassembles and organizes VA claims folder according to established policies and procedures....
Desired Experience: Medical Coding Certification, Microsoft Office
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