• Medical Claim Review

    Molina Healthcare (Seattle, WA)
    …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... more
    Molina Healthcare (01/25/25)
    - Save Job - Related Jobs - Block Source
  • Nurse Medical Mgmt I

    Elevance Health (Seattle, WA)
    ** Nurse Medical Mgmt I - Washington** Location: **This position is primarily a Virtual/Remote role. Ideal candidates** **Must live within 50 miles of the ... more
    Elevance Health (02/06/25)
    - Save Job - Related Jobs - Block Source
  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Seattle, WA)
    …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... more
    Elevance Health (01/01/25)
    - Save Job - Related Jobs - Block Source
  • Nurse /CPC - Clinical Fraud Investigator…

    Elevance Health (Seattle, WA)
    ** Nurse /CPC - Clinical Fraud Investigator Senior - SIU Fraud...control. + Review and conducts analysis of claims and medical records prior to payment. + ... more
    Elevance Health (02/13/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Appeals Nurse (RN): Texas and New…

    Molina Healthcare (Seattle, WA)
    …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 (02/09/25)
    - Save Job - Related Jobs - Block Source
  • Medical Director (Marketplace)

    Molina Healthcare (Seattle, WA)
    …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 (02/06/25)
    - Save Job - Related Jobs - Block Source
  • Medical Director (Medicare)

    Molina Healthcare (Bellevue, WA)
    …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 (02/09/25)
    - Save Job - Related Jobs - Block Source
  • Quality Assurance RN

    Swedish Health Services (Seattle, WA)
    …strategies. Conducts interviews with physicians, independent practitioners, managers, clinical nurse specialists, and staff in order to identify case specific ... more
    Swedish Health Services (02/11/25)
    - Save Job - Related Jobs - Block Source