- Molina Healthcare (San Antonio, TX)
- …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... **Job Duties** + Performs clinical/ medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which… more
- USAA (San Antonio, TX)
- …to include 6 years of experience working as a Registered Nurse ( RN ), Nurse Practitioner (NP), or Medical Doctor (MD) with accountability for highly ... us special and impactful. **The Opportunity** USAA Life Company's Claim Team is seeking a talented ** Medical ...+ Expert Advice: Ability to review complicated medical records and medical claims ,… more
- Molina Healthcare (San Antonio, TX)
- …to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. ... nursing experience with broad clinical knowledge. + Five years experience conducting medical review and coding/billing audits involving professional and facility… more
- Molina Healthcare (San Antonio, TX)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/ medical reviews of… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …Texas is seeking Primary Care Physician(s) as vacancies become available for the medical center and/or CBOC VA Clinics located in San Antonio, Kerrville, New ... of healthcare services through an interdisciplinary team that includes the PCP, RN care manager, LVN, clerical associate as well as other clinical services… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …coordination of health services through an interdisciplinary team that includes the PCP, RN Care Manager, LVN, clerical associate as well as other clinical services ... more mid-level providers. Physicians are expected to provide clinical oversight and review the care provided by mid-level practitioners. Most providers will need to… more