- Alameda Health System (Oakland, CA)
- …Their responsibilities span from managing admissions to ensuring clean claims , identifying trends, and optimizing resource utilization. This role supports ... more
- Molina Healthcare (Columbus, OH)
- …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... more
- Travelers Insurance Company (Walnut Creek, CA)
- …Utilizes evaluation documentation tools in accordance with department guidelines. + Proactively review Claim File Analysis (CFA) for adherence to quality ... more
- Travelers Insurance Company (Rancho Cordova, CA)
- …Utilizes evaluation documentation tools in accordance with department guidelines. + Proactively review Claim File Analysis (CFA) for adherence to quality ... more
- Travelers Insurance Company (Richardson, TX)
- …case resolution. + Review , approve and issue accurate and timely indemnity, medical and expense payments for lifetime/long-term claims . + Determine Value of ... more
- Lincoln Financial Group (Columbus, OH)
- …for conducting initial and ongoing interviews with claimants, obtaining, and reviewing medical records and making timely and ethical claim determinations. You'll ... more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …software for financial care activities including eligibility verifications, pre-authorizations, medical necessity, review /updating of patient accounts, etc. * ... more
- Access Dubuque (Dubuque, IA)
- Claims Processing Representative **Grand River Medical Group** 1 Positions ID: 1405087 Posted On 01/17/2025 **Job Overview** ** Claims Processing ... more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- … medical coding skills to review provider claim appeals for medical necessity, appropriate coding, and pricing of claims for payment. This position is ... more
- Independent Health (Buffalo, NY)
- …collaboration. **Overview** The Utilization Review Nurse (URN) performs clinical review to determine the medical necessity of requested services. The URN ... more
- Travelers Insurance Company (Alpharetta, GA)
- …on collaboration. Imagine loving what you do and where you do it. **Job Category** Claim , Nurse - Medical Case Manager **Compensation Overview** The annual ... more
- CDPHP (Albany, NY)
- …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... more
- Matrix Providers (Aurora, CO)
- Utilization Review Nurse (RN) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... more
- Ascension Health (Baltimore, MD)
- …cases. + Assist departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement and claim denials/appeals. + ... more
- Lincoln Financial Group (Columbus, OH)
- …organization. This position will be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you ... more
- US Tech Solutions (Columbia, SC)
- …following in support of medical claims review and utilization review practices: Performs medical claim reviews and makes a reasonable charge ... more
- University of Pennsylvania (Philadelphia, PA)
- …Occurrences Committee, Environment of Care Committee, Patient Safety Steering Committee, Nursing Claims Review Committee, etc.). + Provides data to committees ... more
- US Tech Solutions (Columbia, SC)
- …following in support of medical claims review and utilization review practices: Performs medical claim reviews and makes a reasonable charge ... more
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