- Molina Healthcare (Omaha, NE)
- JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring ... clinical/ medical reviews of retrospective medical claim reviews, medical claims and...hospital setting, including at least 1 year of utilization review , medical claims review… more
- Molina Healthcare (Omaha, NE)
- …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
- Lincoln Financial (Omaha, NE)
- …organization. This position will be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you ... will act as a clinical resource for Group Protection benefit specialists and claim professionals. You will evaluate medical information to clarify diagnoses,… more
- Lincoln Financial (Omaha, NE)
- …mental health disability claims . You will act as a resource to review , analyze, and interpret medical information as well as assess ongoing interventions ... Protection Clinical organization. You will collaborate with Independent Consulting Physicians, Claims Specialists, and Nurse Disability Consultants to assist… more
- Molina Healthcare (Omaha, NE)
- …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