- Molina Healthcare (Rochester, NY)
- …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
- Molina Healthcare (Rochester, NY)
- …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
- Rochester Regional Health (Rochester, NY)
- …+ Provide ergonomics assessments and training on an ad hoc basis. + Review federal and state safety regulations to ensure program consistency and compliance. + ... practices. + Coordinate program activities with Safety Committees and other agencies. Review incident reports to identify problem areas and incident trends. +… more