- Molina Healthcare (Ann Arbor, MI)
- 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 (Ann Arbor, MI)
- …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 (Ann Arbor, MI)
- …Microsoft Excel (edit/save spreadsheets, sort/filter) **Required License, Certification, Association** Licensed registered nurse ( RN ), Licensed practical ... internal policies, and contract requirements. This position completes a medical review to facilitate a referral to...corresponding medical records to determine accuracy of claims payments. + Review of applicable policies,… more
- University of Michigan (Ann Arbor, MI)
- …Care Management, Registration, MiVisit Business services, clinics and ancillary departments. + Review patient medical records and utilize clinical and regulatory ... Audit and Appeals Specialist has a strong knowledge of medical appeal and audit practices for both the inpatient...Medicare inpatient only list to ensure accurate reimbursement. + Review readmissions and apply payer guidelines. Combine accounts as… more