- 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