- SR International, Inc. (Phoenix, AZ)
- …Candidate needs to obtain their own laptop SOAZ - Posting ID # 5297 - Medical Review Nurse (Local Only/Mostly Remote/Onsite Trainings) Skills Required: * ... intervention, and evaluation *InterQual Criteria *CCI *Coding: CPT, HCPCS, ICD-9 * Medical Claims Review *Statistical analysis *Computer data retrieval and… more
- Molina Healthcare (Mesa, AZ)
- …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... schedule) Looking for a RN with experience with appeals, claims review , and medical coding....clinical/ medical reviews of retrospective medical claim reviews, medical claims and… more
- Lincoln Financial (Phoenix, AZ)
- …for conducting initial and ongoing interviews with claimants, obtaining, and reviewing medical records and making timely and ethical claim determinations. You'll ... through phone and e-mail to gather information regarding the Short Term Disability claim . + Collaborating with fellow case managers, nurse case managers and… more
- Lincoln Financial (Phoenix, AZ)
- …organization. This position will be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you ... will act as a clinical resource for Group Protection benefit specialists and claim professionals. You will evaluate medical information to clarify diagnoses,… more
- Cognizant (Phoenix, AZ)
- …. Draft and submit the medical necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with ... to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical… more
- Sedgwick (Phoenix, AZ)
- …review process including making a recommendation of specialty for the Independent Medical Review process. + Developing and delivering training materials and ... Best Workplaces in Financial Services & Insurance Sr. VP Medical Director **PRIMARY PURPOSE** **:** To evaluate medical...the following: + Conducting reviews on cases where the nurse is seeking treatment plan clarification, claim … more
- U-Haul (Phoenix, AZ)
- …relationships with TPAs, excess carriers, brokers and internal stakeholders to ensure claim efficiency. + Review and approve vendor invoices and third-party ... are handled in accordance with state laws and company claim standards. This position involves the supervision of staff...We're Looking For: + In-depth knowledge of WC laws, claims handling, and medical /litigation processes, with experience… more
- Molina Healthcare (Mesa, AZ)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial… more
- Veterans Affairs, Veterans Health Administration (Phoenix, AZ)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. EDRP Authorized: Former EDRP participants ineligible to ... Clinic Director will work in a team setting with other physicians, nurse practitioners, physician assistants, registered nurses, and support staff assigned to… more
