Claims Review Nurse Jobs

Marsh McLennan Agency - Houston, TX, United States (+1 location)

outcomes Provide guidance regarding potential large settlements Recommend suitable vendor partners, including claims TPAs, nurse triage, and others Review adjuster’s claim action plans; facilitate claims

from: linkedin.com (+1 source) - 9 days ago

Alight Solutions - Jersey City, NJ, United States

. • Supports operational functions via consultation with the Client, vendors, internal leadership, and case managers, and directs and coordinates psychiatric reviews and complex claim discussions related

from: linkedin.com - 4 days ago

AmTrust Financial Services, Inc. - South Jordan, Utah

or for other administrative tasks as needed Performs general maintenance of claims documents in various systems Other administrative tasks as assigned by clinical review nurses, nurse case managers

from: resume-library.com - 3 days ago

Lucas James Talent Partners - Rochester, NY, United States

-required paperwork and medical reports for WC. Participate in claim reviews with WC brokers, insurance carriers and key management personnel. EDUCATION, SKILLS & EXPERIENCE Nurse Practitioner License

from: linkedin.com - 21 days ago

Rising Medical Solutions - Cleveland, OH, United States (+9 locations)

medical claims; analyzing and optimizing bill review procedures and systems; and leading a team of experienced medical bill review auditors, nurse auditors, med-legal nurse, negotiators and related staff

from: linkedin.com - 25 days ago

CVSHealth - Sacramento, CA (+1 location)

and responsibilities in accordance with contract. • Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. • Educates

from: cvshealth.com - 5 days ago

Loyal Source Government Services - Pocatello, ID, United States

professional to evaluate and provide a clear, comprehensive, and concise review of Veterans Affairs (VA) Compensation and Pension Disability claims. You will not decide the percent of disability or rating

from: linkedin.com - 17 days ago

Ethos Risk Services - Austin, TX 78701, USA (+1 location)

Ethos is looking for a full time Case Manager Nurse! This position performs case management for workers' compensation claims based on review criteria and protocols in accordance with state $37.00 - $39.00 per hour

from: applicantpro.com - More than 30 days ago

Christian Health Care Center - Wyckoff, New Jersey

Ridge Behavioral Health (RRBH). The Utilization Review Nurse promotes effective utilization and monitoring of health care resources to achieve desired clinical, financial and resource outcomes. Verifies

from: resume-library.com - 5 days ago

Advocate Health - Allenton, WI

mismatches. Participate in hospital coding denial and appeal processes as directed. Ensure timely review and response to any third-party payer notification of claims where codes are denied. Determine

from: milwaukeejobs.com - 2 days ago