- Berkshire Hathaway Homestate Companies (Omaha, NE)
- …staff, and attorneys. Act as a medical resource in regards to utilization review to Claims Support Nurse , Bill Review, and Claims department. Foster a ... staff, including the claims staff, medical bill review, claims support nurse , special investigations, legal, liens, the call center, and client services.… more
- PMA Companies (Baltimore, MD)
- As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more ... In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions,… more
- Regal Medical Group, Inc. (Northridge, CA)
- …authorization nurse case managers and support staff (coordinators), professional claims review nurses and UM compliance staff to promote quality, cost ... issues, as well as care coordination issues. Oversight of the professional claims review nurse team (nurses/coders), who work with the claims department to… more
- Berkshire Hathaway Homestate Companies (Walnut Creek, CA)
- …results, and are willing to accept ownership for their work product. This Claims Professional is responsible for the management of a caseload of workers compensation ... indemnity claims from inception to resolution, performing initial investigation and...of all other professionals involved in claim, including attorneys, nurse case managers, and investigators, are coordinated to achieve… more
- Rula Health (Charlotte, NC)
- …work for everyone. Minimum qualifications: 1+ years as a psychiatric nurse practitioner with experience with mental health assessment, diagnosis, triage, managing ... state law Board certified as a Psychiatric Mental Health Nurse Practitioner (PMHNP) by the American Nurses Credentialing Center...two weeks with no need to worry about unpaid claims No-show protection: Rula pays you 100% of your… more
- Greenlife Healthcare Staffing (New York, NY)
- Registered Nurse - Nursing Home Surveyor / Complaint Investigator Job ID: #6045 Location: New York, NY Employment Type: Contract / Travel Hourly Rate: $45/hour + ... the Role GreenLife Healthcare Staffing is seeking a Registered Nurse (RN) to serve as a Nursing Home Surveyor/Complaint...Experience : At least 2 years in utilization review, claims , medical review, fraud investigation , or monitoring ;… more
- Constructive Partnerships Unlimited (New York, NY)
- …position is a combined role that encompasses the responsibilities of both the Nurse Administrator and Coordinator of Nursing Education and reports directly to the ... Vice President and Assistant Vice President. As Nurse Administrator, you are responsible for ensuring that all...code of business conduct, the NYS and federal false claims act, whistleblower protections and mandatory reporting. 11. Completes… more
- Elevance Health (Little Rock, AR)
- Anticipated End Date: 2025-08-25 Position Title: Nurse Case Manager I (OB/NICU Experience Preferred) Job Description: The Nurse Case Manager I is responsible for ... rates of reimbursement, as applicable. Assists in problem solving with providers, claims or service issues. Minimum Requirements: Requires BA/BS in a health related… more
- Elevance Health (Richmond, VA)
- …End Date: 2025-07-31 Position Title: Clinical Fraud Investigator II - Registered Nurse and CPC - Carelon Payment Integrity SIU Job Description: Clinical Fraud ... Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU Location:...Performs in-depth investigations on identified providers as warranted. Examines claims for compliance with relevant billing and processing guidelines… more
- Strategic Staffing Solutions (Burlington, VT)
- …with one of our largest clients located in Vermont! Title: Clinical Review Registered Nurse Duration : W2 Contract Location: Remote in Vermont Duration: 3 Month - ... review of health service delivery and utilization and cost data. Assist the claims payer in accurate adjudication of care management approved services as needed.… more
- Erie County, NY (Buffalo, NY)
- …at the Erie County Medical Center Corporation. Examples of Duties A Nurse Practitioner- Dept. of Plastic & Reconstructive Surgery provides expended clinical services ... either: A) One (1) year of experience as a Nurse Practitioner in the certified specialty area; or: B)...through a State or local social service agency. All claims for application fee waiver are subject to verification.… more
- Critical Nurse Staffing (Harriman, TN)
- Registered Nurse - RN Full-Time & Part-Time Hours Available Private duty caregiver, Benefits at 30+ hrs/week Pay Rate: $40.00 - $45.00 per hour Sign On Bonus: $5,000 ... Veterans of the United States Armed Services, Workers Compensation Claims , and former energy workers who want to remain...and job requirements. Qualifications: Current license as a Registered Nurse - RN in the state(s) of practice Current… more
- Critical Nurse Staffing (Albuquerque, NM)
- Job Type Full-time, Part-time Description Registered Nurse - RN Private duty caregiver Full-Time / part-Time Benefits at 30+ hrs./week|$35.00-$45.00 Come work for ... Veterans of the United States Armed Services, Workers Compensation Claims , and former energy workers who want to remain...and job requirements. Qualifications: Current license as a Registered Nurse - RN in the state(s) of practice Current… more
- McLaren Health Care Corporation (Indianapolis, IN)
- …of HMO, PPO, TPA, PHO and Managed Care functions including understanding of claims administration, including CPT-4 codes, revenue codes, HCPCS codes, DRGs, etc. Two ... (2) years' experience in Managed Care Utilization Management, Medical Management, Case Management. BSN. Certified Case Manager (CCM) Certification. more
- Sinceri Senior Living (Nashville, TN)
- …to protect our organization and residents through proactive risk assessment, claims management, and quality improvement initiatives. The position requires a ... Registered Nurse or Licensed Practical Nurse with strong...teams, insurance carriers, and community staff. Essential Job Functions: Claims Management & Insurance Coordination Submit and manage … more
- Avera Health (Sioux Falls, SD)
- …documents and processes worker's compensation. Coordinates with employees, department leadership, claims adjusters and medical providers to assure continuity of care ... hardship to the employer. Required Education, License/Certification, or Work Experience: Registered Nurse (RN) - Board of Nursing An active license in the state… more
- University of Southern California (Pasadena, CA)
- …by the physician as needed. Reviews and codes charge slips, submits insurance claims . Returns patient phone calls. Performs various office and clerical duties. Must ... as needed. Reviews and codes charge slips, submits insurance claims . Returns patient phone calls. Performs various office and...and HMO requests. Relays disability status to adjusters and nurse case managers. Returns patient phone calls in a… more
- Methodist Family Health (Jonesboro, AR)
- Registered nurses report directly to the nurse supervisor they work collaboratively with the health care team to provide holistic care to the acute or transitional ... Licensed Graduate of an Accredited School of Nursing. Current Arkansas Registered Nurse license. Experience with adolescents and children in a psychiatric setting… more
- IntellaTriage (Brentwood, TN)
- …nurses are able to be at ease knowing their patients are in good hands. Our nurse triage services are in high demand, exceeding our growth goals every year for the ... quality small business to the leading provider of after-hours nurse triage in the hospice and home health markets....SNFs, and providers; ensure timely upload into EMR. *Handle claims status inquiries and route appropriately. *Field new enrollment… more
- The Travelers Indemnity Company (Morristown, NJ)
- …internal and/or external resources for specific activities required to effectively evaluate claims , such as Subrogation, Risk Control, nurse consultants, and ... resolving assigned Specialty Liability related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer… more
