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Clinical Nurse Educator
Jacksonville, FL 32202 (Downtown area)
$61,200 - $91,800 a year
Knowledgeable of Medicare claims processing systems (FISS, MCS). Evaluate issues impacting quality/consistency of MR decision making and work with management to...
Desired Experience: ICD-10, RN, Medical Coding Certification, DRG, CPT Coding, Customer Service, ICD-9
Clinical Review Nurse
Mechanicsburg, PA 17050
$52,800 - $79,200 a year
Experience using claims processing system (e.g., MCS/FISS), etc. *. Review and analyze pre and post pay complex health care claims from a medical perspective:....
Desired Experience: RN, ICD-10, Medical Coding Certification, Microsoft Office, CPT Coding, ICD-9
Project Manager - Construction
Colorado Springs, CO 80915
Maintain logs, including inspection/test, change status, claims, submittals, receivables, etc. And advise office assistants to inform reviewers of priority and...
Desired Experience: OSHA 30, Sage, OSHA 10, Project Management, Customer Service, Microsoft Office, Construction Experience, Construction Management, Driver's License, Project Management Software
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RN Reviewer, PDIP

Remote
We are currently seeking a dynamic RN REVIEWER, PDIP to join our team at our office in WOBURN, MA. The PSYCHOTROPIC DRUG INTERVENTION PROGRAM (PDIP) is a unique...
Desired Experience: EMR Systems, RN, Behavioral Health, Microsoft Office, Managed Care

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,...

Disability Claims Nurse

Remote
As a Disability Nurse Claims Reviewer, You Are Responsible for:. You will need the knowledge and skills to conduct thorough investigations of disability claims....
Desired Experience: Microsoft Powerpoint, RN, Microsoft Word, SharePoint

PT/OT Peer Reviewer-Contract Opportunity Only

United States
Participation in group reviewer meetings as scheduled. (we aren’t looking for evening and weekend reviewers). Perform post-service clinical peer reviews of out...
Desired Experience: Microsoft Office

Compliance Specialist 3 (Medical Reviewer)

Salem, OR
$55,548 - $81,300 a year
Knowledge of workers' compensation claim processing. The reviewer often resolves disputes through alternative dispute resolution processes using mediation and...
Desired Experience: Medical Terminology, Administrative Experience, Alternative Dispute Resolution, Workers' Compensation

Clinical Reviewer - Rheumatology - Remote

National Medical Reviews Inc
Chicago, IL +6 locations
Under the direction of the Chief Medical Director, provides peer reviews services, which may include benefit coverage opinions, case reviews, claims auditing,...
Desired Experience: Patient Care
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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

Physician Reviewer - Rheumatology - Remote

National Medical Reviews Inc
Atlanta, GA
Under the direction of the Chief Medical Director, provides peer reviews services, which may include benefit coverage opinions, case reviews, claims auditing,...
Desired Experience: Patient Care
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Rheumatologist Peer Reviewer - Remote

National Medical Reviews Inc
Atlanta, GA +4 locations
Under the direction of the Chief Medical Director, provides peer reviews services, which may include benefit coverage opinions, case reviews, claims auditing,...
Desired Experience: Patient Care, BC/BE
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Legal Packaging Review and Regulatory Affairs Specialist

Groupe Leclerc
Kingsport, TN
Possess knowledge of nutrition claims and other claims related to food. Be second label reviewer if needed for other markets (Canada, UK, Mexico, etc…)....
Desired Experience: Packaging, Microsoft Office
Primary Care Behavioral Health Integration Evaluator
$51.28 an hour
Quality Reviewer of CMT/ProAct Medicaid Claims Data analysis and compile narrative reports highlighting program analysis of PCBHI ICE data....
Desired Experience: Time Management, Behavioral Health, Microsoft Office
Utilization Management Reviewer, RN
Torrance Health IPA
Torrance, CA 90505
Assists in determining status of non-complex claims for reimbursement. The Utilization Management Reviewer, RN works closely with physicians, hospitals, and...
Desired Experience: RN
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