- Molina Healthcare (Dallas, TX)
- …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 (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
- Elevance Health (Grand Prairie, TX)
- ** Nurse /CPC - Clinical Fraud Investigator Senior - SIU Fraud...control. + Review and conducts analysis of claims and medical records prior to payment. + ... more
- Molina Healthcare (Dallas, TX)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... more
- Molina Healthcare (Dallas, TX)
- …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 (Dallas, TX)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …and communicates patterns and trends or professional and comprehensive general liability claims experience to the administrative and medical staff. + Makes ... more