- Molina Healthcare (Georgetown, KY)
- …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... clinical/ medical reviews of retrospective medical claim reviews, medical claims and...Claims Auditing, Medical Necessity Review and Coding experience +… more
- Lincoln Financial Group (Frankfort, KY)
- …for conducting initial and ongoing interviews with claimants, obtaining and reviewing medical records, and making timely and ethical claim determinations. You'll ... are excited to bring on a highly motivated **Group Claims Specialist** to support our ever-growing claims ...managers, and consulting physicians to make appropriate and timely claim determinations. + Reviewing complex medical records… more
- Lincoln Financial Group (Frankfort, KY)
- …organization. This position will be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you ... will act as a clinical resource for Group Protection benefit specialists and claim professionals. You will evaluate medical information to clarify diagnoses,… more
- Molina Healthcare (Georgetown, KY)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge,… more
- Sedgwick (Frankfort, KY)
- …Forbes Best-in-State Employer RN Bill Review **PRIMARY PURPOSE** **:** To review hospital and professional medical bills from providers including complex ... review ; two (2) years of experience with complex medical , legal and consult review ; and two...two (2) years of experience in daily application of nurse auditing, utilization review and bill … more