- Molina Healthcare (Louisville, KY)
- …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... more
- Elevance Health (Louisville, KY)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... more
- Molina Healthcare (Louisville, KY)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... more
- Elevance Health (Louisville, KY)
- ** Nurse /CPC - Clinical Fraud Investigator II - SIU...control. + Review and conducts analysis of claims and medical records prior to payment. ... more
- Molina Healthcare (Louisville, KY)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... more
- Molina Healthcare (Louisville, KY)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... more