- 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: * ... times for training once starting position Compliance Items: Active RN License in state of Arizona Fingerprint Clearance Card...and evaluation *InterQual Criteria *CCI *Coding: CPT, HCPCS, ICD-9 * Medical Claims Review *Statistical analysis… more
- Aveanna Healthcare (Huntsville, AL)
- Position Overview: The RN or PT Executive Director is directly responsible for the administrative and leadership functions associated with all operations of an ... and ensuring compliance with Aveanna's policies and procedures. **We are open to an RN or Physical Therapist for this position. This role is an onsite position and… more
- Aveanna Healthcare (Brainerd, MN)
- …Management/Issue Resolution Plan and implement branch growth strategies Thorough review of financial statements, activity reports, and other performance data ... regulations Oversight if internal billing and collection efforts to generate clean claim Aveanna Healthcare Offers: Quarterly bonus plan 401(k) with Company match… more
- Stanford Health Care (Palo Alto, CA)
- …180 Days or + CCDS - Cert Clinical Document Spec required within 180 Days + RN - Registered Nurse - State Licensure And/Or Compact State Licensure required ... while identifying instances of overpayments and underpayments. Proficiency in healthcare claims analysis, including the ability to review , interpret, and… more
- PharmaCord (Jeffersonville, IN)
- …clearly and articulately Have a positive attitude! Education & Experience: Licensed Registered Nurse 2-3 years nursing with experience in rare disease, ... report it to our Talent Acquisition team immediately at ###@pharmacord.com The Nurse Program Manager plays a pivotal role in optimizing the operational performance… more
- Terumo Medical Corporation (Baltimore, MD)
- …Date: Oct 22, 2025 Req ID: 5264 Location: Baltimore, MD, US Company: Terumo Medical Corporation Department: TIS Sales - Mid Atlantic Terumo Medical Corporation ... (TMC) develops, manufactures, and markets a complete, solutions-based portfolio of high-quality medical devices used in a broad range of applications for numerous… more
- Terumo Medical Corporation (Tampa, FL)
- …Date: Oct 22, 2025 Req ID: 5289 Location: Tampa, FL, US Company: Terumo Medical Corporation Department: TIS Sales - South Florida Terumo Medical Corporation ... (TMC) develops, manufactures, and markets a complete, solutions-based portfolio of high-quality medical devices used in a broad range of applications for numerous… more
- Stanford Health Care (Palo Alto, CA)
- …to leaders and team members on leave policies and practices, including claim filing process; act as liaison betweenteam members, leaders, Benefits, Payroll, WHW ... Leave Team to resolve leave issues; provide follow-up with teammembers on claims , payments and related worker's compensation issues. In collaboration with leader and… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …may include preauthorization, outpatient and inpatient management, case management, retrospective claim review , and delegated management oversight. + Participate ... that they are operating effectively. **What You'll Bring:** + Candidates with a RN License are highly preferred. + Current state credential (eg licensure) that… more
- Terumo Medical Corporation (Boston, MA)
- …Date: Oct 1, 2025 Req ID: 5130 Location: Boston, MA, US Company: Terumo Medical Corporation Department: TIS Sales - New England Terumo Medical Corporation (TMC) ... develops, manufactures, and markets a complete, solutions-based portfolio of high-quality medical devices used in a broad range of applications for numerous areas of… more
- Molina Healthcare (Albuquerque, NM)
- JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring ... hospital setting, including at least 1 year of utilization review , medical claims review...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Buffalo, NY)
- …work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and ... Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in … more
- Molina Healthcare (San Diego, CA)
- …clinical nursing experience. Minimum one year Utilization Review and/or Medical Claims Review . **Required License, Certification, Association** Active, ... clinical/ medical reviews of retrospective medical claim reviews, medical claims and...Nurse (LVN) license in good standing. **Preferred Education** Registered Nurse . Bachelor's Degree in Nursing or… more
- Zelis (St. Petersburg, FL)
- …in an advisory role with management of direct reports required. + Advanced competency in medical claim review and payment integrity preferred. + Ability to ... a team of Clinician's performing clinical reviews of facility claims , including UB's, Itemized Bills and medical ...consistently. + Assess, track and report any delays in claim review or processing to the Manager,… more
- InGenesis (Columbia, SC)
- InGenesis is currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our client located in Columbia, SC. In this role you will ... any questions you may have. Job Duties * Perform medical review /authorization process. * Ensure coverage for...Perform other duties as assigned. Minimum Qualifications * Current Registered Nurse / RN license… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... protocol sets, or clinical guidelines and provide support and review of medical claims and...customer service skills required. **Minimum License Requirement :** California RN license. Delivering world-class health care one patient at… more
- The County of Los Angeles (Los Angeles, CA)
- …be active and unrestricted. Successful candidates are required to provide proof of their Registered Nurse ( RN ) License and Basic Life Support (BLS) ... REGISTERED NURSE I/RELIEF NURSE ...vaccination against COVID-19 or request an exemption for qualifying medical or religious reasons during the onboarding process. Candidates… more
- US Tech Solutions (Columbia, SC)
- …to elicit behavior change and increase member program engagement. + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate ... temp to hire)** **Job Description:** + Must be an RN in SC and have an active and unrestricted...with triage when needed. **Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria… more
- The County of Los Angeles (Los Angeles, CA)
- REGISTERED NURSE I, SHERIFF (CORRECTIONAL HEALTH) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2930992) Apply REGISTERED NURSE ... is currently offering up to 20% bonus for full-time Registered Nurse I, Sheriff positions hired by...vaccination against COVID-19 or request an exemption for qualifying medical or religious reasons during the onboarding process. Candidates… more
- MyFlorida (Orlando, FL)
- …that all verbal orders, including telephone orders from attending physicians, are reviewed by a registered nurse . + If no RN is available, receive all ... reflective of resident's status, and providing supervision and guidance to the Registered ( RN ), Licensed Practical Nurse (LPN), Certified Nursing… more
