- Molina Healthcare (Iowa City, IA)
- …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
- Sedgwick (Cedar Rapids, IA)
- …professional needs. **PRIMARY PURPOSE** : Provides disability case management and routine claim determinations based on medical documentation and the applicable ... your 2+ years' experience in a office setting or medical experience and grow with us! + A stable...system. + Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims . + Evaluates and… more
- Molina Healthcare (Iowa City, IA)
- … claims with corresponding medical records to determine accuracy of claims payments. + Review of applicable policies, CPT guidelines, and provider ... policies, CPT guidelines, internal policies, and contract requirements. This position completes a medical review to facilitate a referral to law enforcement or… more
- Molina Healthcare (Iowa City, IA)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial… more
- Veterans Affairs, Veterans Health Administration (Coralville, IA)
- …the outpatient clinic setting. This announcement will be posted as a Physician, Nurse Practitioner, and Physician Assistant for one position. Please apply to the ... Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that...provider. Physicians are expected to provide clinical oversight and review . Supervising or collaborating responsibilities and performance will be… more