- Molina Healthcare (Fort Worth, TX)
- …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... more
- Sedgwick (Fort Worth, TX)
- …staff meetings; keeps staff abreast of policy and procedure changes. + Provides oversight of medical bill review nurse unit that provides high level clinical ... more
- Elevance Health (Grand Prairie, TX)
- ** Nurse and CPC - Clinical Fraud Investigator II -...control. + Review and conducts analysis of claims and medical records prior to payment. Researches ... more
- Elevance Health (Grand Prairie, TX)
- **Telephonic Nurse Case Manager II** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.** ... more
- Veterans Affairs, Veterans Health Administration (Dallas, TX)
- …by the VHA Education Loan Repayment Services program office after review of the EDRP application. Responsibilities Core responsibilities include leading and ... more
- Sedgwick (Fort Worth, TX)
- …the ADA process for claimants requesting accommodations under the ADAAA; to review complex medical information for temporary and permanent accommodation ... more
- Molina Healthcare (Fort Worth, TX)
- … claims with corresponding medical records to determine accuracy of claims payments. + Review of applicable policies, CPT guidelines, and provider ... 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