- Molina Healthcare (Spokane, WA)
- …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
- Molina Healthcare (Spokane, WA)
- …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 (Spokane, WA)
- …the Spokane VAMC-highly professional services that are critical components of the Medical Center's health care mission. Incumbent is responsible for the quality of ... offered at VAMC Spokane. Coordinates and provides clinical oversight of physicians, nurse practitioners, and other professionals who provide or support provision of… more