- Molina Healthcare (Vancouver, WA)
- 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 (Vancouver, WA)
- …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 (Vancouver, WA)
- For this position we are seeking a ( RN ) Registered Nurse who...for a RN with experience with appeals, claims review , and medical coding. ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
- Molina Healthcare (Vancouver, WA)
- …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
- Molina Healthcare (Vancouver, WA)
- …or equivalent combination of relevant education and experience. * Advanced Practice Registered Nurse (APRN) license. License must be active and unrestricted ... claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees...officer. * Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review … more
- PeaceHealth (Vancouver, WA)
- … review and management of unexpected outcomes, serious patient events and medical errors. Facilitates and/or co-facilitates the review and investigation of ... clinical risk management risk investigations and response to events, potential claims , and grievances presented against caregivers, physicians and the organization… more