Clinical Claims Review Nurse & Quality Analyst
CVS Health Corporation
CVS Health Corporation is seeking a Registered Nurse to review and interpret clinical documentation from medical records, apply clinical criteria for post-service claims, and coordinate resolutions independently with clinician support. The role also serves as a resource for customer service and claims teams, with responsibilities including training new staff and cross-training existing colleagues to uphold quality standards. #J-18808-Ljbffr CVS Health Corporation
$26.01 - $68.55 per hour
...accountable and prioritize safety and quality in everything we do. Join us... .... This role requires the nurse to exercise clinical judgment and perform the following duties: Review and interpret clinical... ...and policies for post-service claims Coordinate clinical resolutions...ClaimsHourly payFull timeTemporary workLocal area- ...the career opportunities as a Registered Nurse Pain Clinic you want with your current employer? We... ...be responsible for delivering high-quality, patient-centered care in line with the... ...Nurse Pain Clinic opening. We promptly review all applications. Highly qualified candidates...SuggestedTemporary workFlexible hoursShift work
$37 - $55.5 per hour
...Position Overview Begin your nursing career with confidence... ...offers intensive clinical training, mentorship from... ...Practice, Nursing Quality, Nursing Professional Development... .... We also continuously review compensation to ensure... ...make this claim, we back it up with action...ClaimsHourly payFull timePart timeWork experience placementSeasonal workLocal areaImmediate startRelocation packageAll shiftsFlexible hoursShift work$34 - $38 per hour
...since 1935. The high-quality, expert, and compassionate... ...Provide compassionate nursing care to patients... .... Support and enhance clinical and operational activities... ...interviewing patient; reviewing and/or recording... ...to support efficient claims processing. Performs...ClaimsHourly payWork at officeRelocation packageFlexible hoursAfternoon shift$27.02 - $48.55 per hour
...the appropriate medical team to promote quality and cost effectiveness of medical care.... ...state of Missouri. This team performs clinical reviews for medical and behavioral health service... ...Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 2 -...SuggestedHourly payFull timePart timeWork at officeRemote workWork from homeMonday to FridayFlexible hours$33.57 - $51.39 per hour
...development in accordance with the Nurse Practice Act, United Health... ...degree in Nursing 2 years of clinical nursing experience in an acute... ...leads. We also continuously review compensation to ensure market... ...many organizations make this claim, we back it up with action. We...ClaimsHourly payFull timePart timeSeasonal workLocal areaFlexible hoursShift work$34 - $38 per hour
...Parenthood Great Plains Nursing Position Planned... ...since 1935. The high-quality, expert, and compassionate... .... Support and enhance clinical and operational... ...interviewing patient; reviewing and/or recording medical... ...to support efficient claims processing. Performs...ClaimsHourly payFull timeWork at officeRelocation packageFlexible hoursAfternoon shift- ...Position Title \n \n \nAmbulatory Clinic Nurse (RN)- ENT- endocrine\n \n \nDays - Full... ...to who care is delegated to achieve quality patient care outcomes. The RN also must... ...patients through observation and chart review to facilitate appropriate follow-up with...Full timeReliefShift work
$25k
...Surgical Neuro Registered Nurse (RN) at United Health... ...(UHS) provides high-quality, patient-centered nursing... ...degree in Nursing Previous clinical nursing experience in... .... We also continuously review compensation to ensure... ...make this claim, we back it up with action...ClaimsHourly payFull timePart timeSeasonal workLocal areaRelocation packageFlexible hoursShift workNight shift- ...Independent Medical Exams And Peer Reviews Dane Street, a certified "Great... ...Area Job Summary: Utilizes clinical expertise, and reviews disability claims by providing an interpretation of... ...including identifying and responding to quality assurance issues, complaints,...ClaimsFor contractorsMonday to Friday
$27.02 - $48.55 per hour
...Purpose: Performs concurrent reviews, including determining member... ...appropriate level of care Reviews quality and continuity of care by... ...medically necessity based on clinical policies and guidelines... ...from an Accredited School of Nursing or Bachelor’s degree in Nursing...Hourly payFull timePart timeWork at officeRemote workFlexible hours$29.09 - $46.55 per hour
...and spiritual needs through observation, interviews, and review of medical records and clinical data. Develops and implements patient care plans in... ...interdisciplinary team, observing outcomes in accordance with nursing standards. Demonstrates competency in therapeutic and...Work at officeLocal area$70k
...to build sustainable outpatient specialty clinics — keeping care local and restoring... ...disclosure questionnaire covering malpractice claims history, licensure actions, and similar risk... ...for leadership meetings and program reviews. Contribute to the annual recruiting analysis...ClaimsFull timeContract workFor contractorsLocumLocal areaRemote workShift workAfternoon shift- ...are prepared for success in clinical practice, education, public health... ...improved oral health and quality of life for the communities we... ...Materials After initial review by the committee all uploaded... ...one of Kansas City's biggest claims to fame is its food, especially...ClaimsFull timeCasual workWork at officeLocal area
- ...benefits, and coverage Submit and follow up on dental insurance claims Review EOBs, denials, and outstanding claims Explain treatment... ...plans confidently and help patients schedule care Support the clinical team with coordination and communication Maintain accurate patient...ClaimsFull timeMonday to Thursday
- ...for you. With mentorship opportunities, clinical education courses, professional certification... ...We are seeking a Registered Nurse for our CHF Clinic to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry...Temporary workFlexible hoursWeekend work
- ...Description Utilization Review Manager - KVC Missouri... ...will ensure that all clinical and medical services for... ...to provide high-quality behavioral healthcare to... ...an Associate degree in Nursing. Licensure: Registered... ...Experience with accounting or claims for billing resolution....ClaimsRemote work
- ...expertise in healthcare billing, medical coding, claims management, insurance reimbursements, and... ...Cycle Management (RCM) process. Review and interpret medical records and... ...patients. Coordinate with hospitals, clinics, physicians, and payers to resolve billing...Claims
$600 - $750 per day
...Description Job Description Nurse Practitioner – Veteran... ...helping them in their disability claim process. ~ Enjoy a low-stress... ...just 1-6 Veterans per day. ~ Review records and complete... ...provided technology, training, and clinical support. What You WON’T Do...ClaimsContract workPart timeFlexible hoursShift workWeekend work1 day per week- ...Position Title Revenue Cycle Quality & Training Analyst-Access/PFS/HIM Southlake Campus Position... ...to conduct quality and assurance reviews and productivity reporting.... ...be able to perform the professional clinical and or technical competencies of the...Full timeWork at office
$78.6k - $117.9k
...plus AK. The opportunity: In the Senior Clinical Risk Consultant role, you will use prior... ..., and professional experience to review claims, underwriting prospects and renewals to... ...diverse range of people Active Registered Nurse license 5+ years of clinical nursing experience...ClaimsWork at officeLocal areaFlexible hours- ## Ambulatory Clinic Nurse (RN)- Clinic Float PoolApply: Kansas City, KS: Full time: Posted Today... ...to provide efficient patient flow and quality patient care and satisfaction.* Provides... ...on lab results after provider has reviewed* Orders patient care and clinical supplies...Full timeWork at office
- Ambulatory Clinic Nurse (RN) - Center for Advanced Medicine Our nurses are leaders and decision makers, working closely with physicians to... ...coordination. You will conduct nurse visits where you review care protocols, educate patients, and administer injections or...Full timeReliefShift work
$450 - $550 per day
...: Exciting Opportunity for Nurse Practitioners – Part-Time available... ...them in their disability claim process. Enjoy a low-stress... ...just 1-5 Veterans per day. Review records and complete... ...provided technology, training, and clinical support. What You WON’T Do:...ClaimsDaily paidPart timeFlexible hoursShift workWeekend work3 days per week1 day per week- ...Position Title \n \n \nAmbulatory Clinic Nurse Care Coordinator (RN) - Float pool\n \... ...Coordinator focuses on patient safety and the quality of nursing care by identifying and... ...of health and wellness. \n Maintains/reviews patient records, charts and other pertinent...Work at office
- ## Clinic NurseApplylocations: Buffalo - Ashtime type: Part timeposted on: Posted Todayjob... ...*Job Description:****Job Title:** Clinic Nurse**Location:** Bolivar & Buffalo, Missouri*... .... • Conduct medication administration reviews and collaborate on medication management...Full timePart timeLocal areaShift work
$80 per hour
...network of licensed clinicians to deliver high-quality care to individuals, couples, and... ...for no-shows, late cancellations, & denied claims Why Join Rula? Our dedicated therapist... ...profile that highlights your specialities and clinical approach, making it easier for the right...ClaimsHourly payFor contractorsPrivate practiceWork at officeRemote work- ...is comprised of independent contract reviewers (1099) compensated on a per-case... ...across the country for objective, high-quality medical evaluations. \n Key Responsibilities... ...orthopedic issues \n Respond to clinical queries to support claims management \n Deliver detailed...ClaimsContract workFlexible hours
$600 - $750 per day
Nurse Practitioner - Veteran Disability Exams (1099, Part-Time) Location... ...them in their disability claim process. Enjoy alow-... ...seeing just 1-6 Veterans per day. Review records and complete assessments... ...provided technology, training, and clinical support. What You WON’T Do: No...ClaimsContract workPart timeFlexible hoursShift workWeekend work1 day per week$2,164 per week
...Registered Nurse (RN) | Outpatient Clinic Location: Kansas City, KS Agency: AHS Staffing Pay: $2,164 per week Contract Duration... ...therefore, we work quickly and diligently to supply the highest-quality candidates to our clients across the nation, including...Hourly payWeekly payDaily paidPermanent employmentFull timeContract workTemporary workImmediate startFlexible hoursShift work
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