- Molina Healthcare (St. Petersburg, FL)
- 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 (St. Petersburg, FL)
- …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
- 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
- Molina Healthcare (St. Petersburg, FL)
- …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
- HCA Healthcare (Sun City Center, FL)
- …related field required; Master's Degree preferred . Current Florida licensure as a Registered Nurse preferred _**If serving as facility's primary Risk Manager, ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more