29 Claims Review Nurse Jobs
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Claims Specialist Marsh McLennan Agency - Houston, TX, United States 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 9 days ago
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Behavioral Health Physician Lead-Leave of Absence 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 4 days ago
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Managed Care Claims Assistant I 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 3 days ago
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Occupational Health Nurse Practitioner 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 21 days ago
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Director of Specialty Bill Review Services - Remote Rising Medical Solutions - Cleveland, OH, United States 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 25 days ago
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Customer Service Representative CVSHealth - Sacramento, CA 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 5 days ago
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Nurse Practitioner/Physician Assistant 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 17 days ago
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Case Management Nurse Ethos Risk Services - Austin, TX 78701, USA 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 More than 30 days ago
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Utilization Review Nurse, RN 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 5 days ago
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Hospital Coding Quality Specialist - REMOTE 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 2 days ago
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