- Molina Healthcare (Orlando, FL)
- …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
- MyFlorida (Orlando, FL)
- REGISTERED NURSE Date: Jan 22, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 845312 Agency: Veterans Affairs Working Title: REGISTERED NURSE Pay Plan: Career Service Position Number: 50009834 Salary: $66,414.40 Posting… more
- Molina Healthcare (Orlando, FL)
- … 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
- AdventHealth (Altamonte Springs, FL)
- …all Inpatient and Outpatient clinical services across the system, as well as review and correct charge errors. The ability to effectively communicate with command of ... decision regarding other action. . Various types of denial review , appeal, further action which includes but is not...strategic focus. . Able to defend and appeal denied claims via both written and verbal communication in clear… more
- Sedgwick (Orlando, FL)
- …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