- LA Care Health Plan (Los Angeles, CA)
- Payment Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full ... to support the safety net required to achieve that purpose. Job Summary The Payment Integrity Nurse Coder RN III is responsible for investigating,… more
- Highmark Health (Little Rock, AR)
- …and member satisfaction. The incumbent is responsible for the implementation of effective Payment Integrity strategies on a pre- payment and retrospective ... with established industry and corporate standards and are within the Payment Integrity Clinician's professional discipline.Effectively function in accordance… more
- Molina Healthcare (NE)
- …level of care, inpatient readmission, and any opportunities identified by the payment integrity analytical team; makes decisions and recommendations pertinent to ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal...criteria supporting all recommendations for denial or modification of payment decisions. + Serves as a clinical resource for… more
- UPMC (Pittsburgh, PA)
- …will play a crucial role in upholding our standards and ensuring the highest level of integrity in our operations. Join us and be part of a team that values your ... + Knowledge of coding/classification systems appropriate for inpatient /outpatient, DRG prospective payment system or office setting E/M codes. + Experience in an… more