- Molina Healthcare (Sterling Heights, MI)
- …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
- R1 RCM (Detroit, MI)
- …working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to appeal denied and underpaid claims . + Apply clinical judgment and ... Coding Appeals Nurse ** , you will help review and interpret medical records to draft...and underpaid claims . Every day you will review medical records to ensure appropriate coding… more
- Molina Healthcare (Sterling Heights, MI)
- … 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
- Sedgwick (Detroit, MI)
- …the ADA process for claimants requesting accommodations under the ADAAA; to review complex medical information for temporary and permanent accommodation ... are driven to deliver great work. + Apply your medical /clinical or rehabilitation knowledge and experience to assist in...the next round, a recruiter will be in touch. \# nurse Sedgwick is an Equal Opportunity Employer and a… more