• Medical Claim Review

    Molina Healthcare (St. Petersburg, FL)
    …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
  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Tampa, FL)
    …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
  • Telephonic Nurse Case Manager II

    Elevance Health (Tampa, FL)
    **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)
    - Save Job - Related Jobs - Block Source
  • ADA Accommodation Specialist

    Sedgwick (Tampa, FL)
    …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)
    - Save Job - Related Jobs - Block Source
  • Investigator, Coding SIU (Remote)

    Molina Healthcare (St. Petersburg, FL)
    claims with corresponding medical records to determine accuracy of claims payments. + Review of applicable policies, CPT guidelines, and provider ... more
    Molina Healthcare (12/15/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Representative II

    Elevance Health (Tampa, FL)
    …Finder and follows up with provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. + ... more
    Elevance Health (01/25/25)
    - Save Job - Related Jobs - Block Source