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CareerBuilder Apply Only
CAREERBUILDER APPLY

Full-Time

To provide clinical expertise in the application of medical and reimbursement policies within the claim adjudication process through claim review, medical record review and research. To provide expert knowledge in CMS, NCCI, AMA and other nationally publi...

Confidential

Spokane, WA

CAREERBUILDER APPLY

Full-Time

Westborough Behavioral Healthcare Hospital will be opening in the Summer 2017! We have an exciting opportunity for a Director of Utilization Management/Review. Reporting to the Chief Financial Officer, this position manages the daily operations of the Uti...

Westborough Behavioral Healthcare Hospital

300 Friberg Parkway
Westborough, MA

CAREERBUILDER APPLY

Full-Time

We are looking for a motivated individual who is excited about the possiblilty for a position with great autonomy. Within this role you will be traveling to different behaviroal health oranizations and Doing the responsibilities as listed below. If you ar...

Boston, MA

CAREERBUILDER APPLY

Full-Time

Prior Authorization Nurse / Concurrent Review Nurse Looking for full-time nurses of all backgrounds to staff a brand new department with a major insurance company. Job Description: Promote the quality and cost effectiveness of medical care by applying cli...

Detroit, MI

Full-Time

CPR required RN Required 1 year of experience required The Appeals and Medical Review Nurse works closely with the clinical, financial departments and physicians to minimize the impact of denials through preparing and overseeing the appeals efforts in the...

Longview, TX

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CAREERBUILDER APPLY

Full-Time | Pay: $33.00 - $34.00/hour

Are you an experienced RN Medical Claims Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Medical Claims Review Nurse? Do you want the chance to advance your career by joining a rapidly growing company? If you answe...

Spokane, WA

CAREERBUILDER APPLY

Full-Time/Part-Time

Job Summary: To provide clinical expertise in the application of medical and reimbursement policies within the claim adjudication process through claim review, medical record review and research. To provide expert knowledge in CMS, NCCI, AMA and other nat...

Confidential

Spokane, WA

Full-Time | Pay: $33.00 - $34.00/hour

An insurance company in downtown Spokane is looking for a qualified nurse for a non-patient interfacing role. Managers are looking for candidates with clinical experience from a hospital (Preferred) Job Summary: To provide clinical expertise in the applic...

Spokane, WA

CAREERBUILDER APPLY

Full-Time

A perfect opportunity for someone interested in an insurance/medical administrative role as entry level or with previous experience in the medical field such as medical office, medical coding, hospital worker, hospice, or nursing home. Full-Time with outs...

Texarkana, TX

CAREERBUILDER APPLY

Full-Time

This is not a remote position; our office is located in Carrollton, TX. Job Summary: The Nurse Reviewer is responsible for conducting concurrent and retrospective chart review for clinical, financial and resource utilization information. To capture the cl...

Cantex Continuing Care Network

Carrollton, TX

CAREERBUILDER APPLY

Full-Time

Overview: The Medical Review Subject Matter Expert (SME) provides support to the Payment Error Rate Measurement (PERM) Review Contract (RC) team. This position functions as a resource and subject matter expert on problem solving Medical Review issues that...

Rockville, MD

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CAREERBUILDER APPLY

Full-Time

The Quality Assurance Analyst is responsible for conducting a quality review of all Equian externaldocuments, internal process review and reporting quality assuranceresults. This position also conducts research as required to supportaudit exceptions an...

Golden, CO

Full-Time

RESOLUTE TREATMENT FACILITY Clinical Utilization Review Manager Position Summary Performs utilization reviews to ensure adherence to federal regulations. Assist in maintaining records, answering correspondence and preparing and disseminating reports. Fami...

Indianapolis, IN

Full-Time

POSITION DESCRIPTION: Scans and imports electronic patient medical records, identifies key data elements and documents in the medical record and accurately interprets and extrapolates into IHA patient EHR charts. Assists with ICS and Fax Server training....

IHA

24 Frank Lloyd Wright Drive
Ann Arbor, MI

2w
2 weeks ago

Full-Time | Pay: $32.00 - $35.00/hour

Position: RN Clinical Review Nurse Location: Bloomington, MN Duration: Full-time Job Info Reviews and interprets patient records and compares against criteria to determine medical necessity and appropriateness of care; determines if the medical record doc...

Bloomington, MN

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CAREERBUILDER APPLY

Full-Time

Required License, Certification, Association Active, unrestricted State Registered Nursing (RN) license in good standing. Job Summary Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding co...

Spokane, WA

Full-Time

POSITION SUMMARY: Provides overall coordination in the delivery of medical services and discharge planning for a specified patient population. Performs concurrent and retrospective review of patient medical records for purposes of utilization review, comp...

Las Palmas Del Sol Healthcare

El Paso, TX

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CAREERBUILDER APPLY
2w
2 weeks ago

Contract to Hire

Title: Care Review Clinician Location: Washington St (WA) 99201 Duration: 4 months contract , cont to perm Role Description: To provide clinical expertise in the application of medical and reimbursement policies within the claim adjudication process throu...

Spokane, WA

Part-Time | Pay: $11.00 - $11.50/hour

The purpose of an Emergency Department Records Coordinator (EDRC) is to act asa coordinator for the timely and effective acquisition, detailed review,and reconciliation and processing of patient records necessary to produce aclaim form or billing state...

Savannah, TN

CAREERBUILDER APPLY

Full-Time

Medical Record Technician / Practitioner The position maintains the medical records of the center in accordance with policies and procedures established for the medical record keeping practices. DUTIES AND RESPONSIBILITIES: Are determined by the center an...

850 East Butler Road
Greenville, SC

CAREERBUILDER APPLY

Full-Time | Pay: $36.00 - $39.00/hour

Utilization Review RN – Managed Care Boston, MA ** This a Full-Time, Benefits available, CONTRACT-TO-HIRE position, expected to convert to a permanent position after 3-4 months! * Your Job Summary: The Utilization Review Nurse is responsible for utilizati...

Boston, MA

View 1 more

Full-Time

UTILIZATIN REVIEW COORDINATOR To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed must be representative of the knowledge, skills, minimum education, training, licensure, expe...

LORETTO HOSPITAL

645 South Central Avenue
Chicago, IL

CAREERBUILDER APPLY

Full-Time

Primary Function: Responsible for telephonic management of care between third-party payors and services provided at Harmony. Collects reviews and presents clinical information in order to obtain authorization of care. Supervision: Supervised by the Direct...

Confidential

1600 Fish Hatchery Road
Estes Park, CO

Full-Time

POSITION DESCRIPTION Job Title: Clinical Review Specialist Department: Reimbursement Reports to: Manager of Clinical Review FLSA Status: Exempt Position Summary: Manages submission processes where authorization, re-authorization, and utilization processes...

121 Gamma Drive
Pittsburgh, PA

Full-Time

Description The Regional Manager, Medical Peer Review is accountable for a comprehensive peer review process required by the Governing Board of CHRISTUS Spohn Health System, as described in the Medical Staff Bylaws. This position is responsible for perfor...

600 Elizabeth Street
Corpus Christi, TX

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