• Medical Claim Review

    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
    Molina Healthcare (01/25/25)
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  • Senior Manager - Bill Review

    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
    Sedgwick (01/30/25)
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  • Nurse and CPC - Clinical Fraud Investigator…

    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 (12/31/24)
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  • Telephonic Nurse Case Manager II

    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
    Elevance Health (01/30/25)
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  • Psychiatrist - Medical Director - PC Mental…

    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
    Veterans Affairs, Veterans Health Administration (01/30/25)
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  • ADA Accommodation Specialist

    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
    Sedgwick (01/28/25)
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  • Investigator, Coding SIU (Remote)

    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
    Molina Healthcare (01/21/25)
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  • Director QA/PI/Risk Management

    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
    Dallas Behavioral Healthcare Hospital (01/15/25)
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