Legal Nurse: Medical Claims & Utilization Review Expert
Rising Medical Solutions, Inc
Rising Medical Solutions, LLC is seeking a Legal Nurse to evaluate medical necessity within various claims such as auto, general liability, and workers’ compensation. An ideal candidate will possess an Associate or Bachelor’s Degree in nursing and an active RN license, with a minimum of 5 years experience in clinical or legal settings. Responsibilities include analyzing demand packages, utilizing evidence-based guidelines, and maintaining collaborative relationships. The company offers competitive salary and benefits, including 401k matching and generous time off. #J-18808-Ljbffr
- ...Rising-Medical-Solutions is looking for a Legal Nurse in Chicago, IL to evaluate medical necessity for auto, general... ..., and workers' compensation claims. The ideal candidate will possess... ...experience. Responsibilities include reviewing demand packages and medical records...MedicalLegalClaims
- ...Rising Medical Solutions is seeking a full-time Utilization Review Nurse in Chicago, IL. The role involves handling various aspects of the Utilization Review Process, including assessing healthcare claims and authorizations, while collaborating effectively with a variety...MedicalClaimsFull timeFlexible hours
- ...Rising Medical Solutions, LLC is seeking a full-time Utilization Review Nurse in Chicago, Illinois. In this role, you will perform the comprehensive Utilization Review Process, ensuring claims are accurately assessed and documented. Your clinical insights will guide the...MedicalClaimsFull timeFlexible hours
- ...Overview Rising Medical Solutions has an opening for a Utilization Review Nurse. We are a bill review and cost containment company focused on fixing the broken healthcare... ...system by reducing the cost of healthcare claims through bill review, case management, and...MedicalClaimsFull timeTemporary workMonday to FridayFlexible hours
- ...Job Title: Utilization Review Nurse Location: Remote in IL, TX, NM, MT or OK Duration: 6+ months... ...to optimize member benefits, evaluate medical necessity and promote effective use of... ...coding (CPT/HCPCS/ICD-10), and overall claims process a plus • Knowledge of National...MedicalClaimsContract workLocal areaRemote work
- ...Rising Medical Solutions, LLC is seeking a Lead Legal Nurse in Chicago, IL. This role is essential for evaluating medical services within claims while leading the demand package product expansion.... ...degree. Responsibilities include reviewing medical documentation and...MedicalLegalClaims
- ...Rising team where our new Legal Nurse plays a critical role in evaluating the medical necessity,... ...workers' compensation claims. This role combines clinical... ...expertise with analytical review to support claim adjudication... ..., and cost drivers Utilize evidence-based guidelines...MedicalLegalClaims
- Rising Medical Solutions is seeking a Lead Legal Nurse in Chicago, IL to evaluate medical necessity and cost within claims related to auto liability and workers’ compensation. The ideal candidate... ...include evaluating demand packages, utilizing evidence-based guidelines, and...MedicalLegalClaims
- ...Rising Medical Solutions in Chicago seeks a Legal Nurse to evaluate medical necessity and appropriateness in various claims. Candidates should have an Associate or Bachelor's Degree in nursing and an active RN license. Responsibilities include assessing demand packages...MedicalLegalClaims
- ...Rising-Medical-Solutions in Chicago is seeking a Lead Legal Nurse to play a critical role in evaluating medical necessity and appropriateness in auto, general liability, and workers’ compensation claims. The ideal candidate should possess an Associate or Bachelor’s Degree...MedicalLegalClaims
- ...SUMMARY The Utility Asset Manager is responsible for... ...investment goals. Review and advise on organizational... ...company interests, and legal, tax, and other... ...Information & Testing, Family & Medical Leave, protected... ...complaint or discrimination claim. The "Know Your...MedicalLegalClaimsImmediate startWorldwide
- ...Innovative Systems Group is seeking a Registered Nurse for remote positions in IL, TX, NM, MT, or OK. The role involves collaborating... ...with healthcare providers to optimize member benefits and evaluate medical necessity, ensuring compliance with established guidelines....MedicalRemote work
$87.6k - $97k
...catastrophic injuries. Our nurses will be responsible for... ...employees receive medically appropriate healthcare... ...holistic approach for each claim. These responsibilities may include utilization review, pharmacy oversight and... ...adheres to ethical, legal, accreditation and regulatory...MedicalLegalClaimsWork experience placementWork at officeFlexible hours$25 - $35 per hour
...compensation files in a legal setting.... ...courteous support. • Review case materials for completeness... ...experience in a legal or claims-focused environment. •... ...professionals, include medical, vision, dental, and life... ...apply their expertise and utilize our proprietary AI to find...MedicalLegalClaimsLong term contractContract work- ...Description Job Description The Legal and Compliance Team at... ...* Initial review of third-party contracts... ...dockets. * Manage insurance claims from initial claim... ...Employer-paid benefits (Medical, Dental, and Vision) *... ...property lifecycle by utilizing our data driven analytical...MedicalLegalClaimsLocal areaFlexible hours
$55 - $70 per hour
...employment matters, and legal issues affecting both... ...investigations, and contract review while helping the... ...for employment-related claims. • Oversee employment... ...professionals, include medical, vision, dental, and life... ...their expertise and utilize our proprietary AI to find...MedicalLegalClaimsLong term contractContract workPart timeLocal area- ...matters, workers’ compensation, medical malpractice, and related claims is adding an Attorney to... ...claims, and provide clear legal guidance with empathy and... ...settlement Draft and review demands Negotiate with... ...apply their expertise and utilize our proprietary AI to find...MedicalLegalClaims2 days per week
- ...Nurse Analyst The Nurse Analyst is responsible for collecting... ...jury. Additionally, they will review, analyze, interpret, and prepare detailed summaries of: medical records; charts; progress... ...coding; CPT coding; and, Medicaid claims/utilization data. Qualifications...MedicalClaimsWork experience placementWork at office
- ...Rising Medical Solutions is looking for a Utilization Review Nurse to manage all aspects of the Utilization Review Process in Chicago, Illinois. The successful candidate will utilize evidence-based guidelines to ensure proper authorization and maintain collaborative relationships...Medical
- ...MBOS is seeking a skilled Utilization Management and Appeals Specialist/CDI Expert in Hillside, IL, to review medical records, determine medical necessity, and manage the appeals... ...process. The ideal candidate is a Registered Nurse or an International Medical Graduate with...MedicalFull time
- ...Assists with docket involving Defense Base Act claims by: providing sound legal analysis, drafting petitions and... ...Department of Labor and opposing counsel. Review, analyze and summarize claims documents including medical records, incident reports, and employment...MedicalLegalClaimsImmediate start
$54.75k - $97.5k
...Auto Casualty Claims Specialist Are you an experienced Auto Bodily... ...& RESPONSIBILITIES: Review & determine course of action on each file assigned, utilizing technical knowledge &... ...hybrid/remote ~ Knowledge of legal and medical terminology ~ Excellent negotiation...MedicalLegalClaimsFull timeTemporary workWork at officeRemote workFlexible hours$105k - $160k
Senior Specialist II, Claims Technician Join AXIS Capital as... ...development. Utilize working knowledge of the legal frameworks and claims handling... ...and other claim details. Review contracts for risk transfer... ...benefits package including medical plans for you and your family...MedicalLegalClaimsWork at office3 days per week- ...Medicine physicians to conduct Independent Medical Exams (IME) and Peer Reviews. This opportunity allows you to customize your... .../South Chicago Area JOB SUMMARY: Utilizes clinical expertise, and reviews disability claims by providing an interpretation of the medical...MedicalClaimsFor contractorsMonday to Friday
- ...sponsor and site monthly claims. File CEP application... ...Statement of Affairs. Legal notices for all... ...educational workshops, reviewing publications and keeping... ...others; work with data utilizing defined and similar processes... ...and Personal Days Medical, dental, vision, and...MedicalLegalClaimsWork at office
$70k - $85k
...and spinal cord tumors. Utilizing next-generation... ...All applicants must be legally authorized to work in... ...deep familiarity with medical necessity standards, payer... ...submit, track, and resolve claims. Tracking,... ...reporting and leadership reviews. Knowledge, Skills,...MedicalLegalClaimsFull timeWork at officeLocal area$117k - $140k
...related to complex insurance claims analysis and representing clients... ...about delivering exceptional legal services. This position is... ...liability, transportation, and medical malpractice claims. Conducting... ...Timeline Application Our team will review your application. Please...MedicalLegalClaimsWork at office$1,000 per month
...estimates, and settle claims promptly and... ...Customer Service Expert -you'll live into... ...performing detailed reviews of damage and interpreting... ...with all legal and business standard... ...Problem Solver -you'll utilize multiple tools to... ...of the Family and Medical Leave Act (FMLA)...MedicalLegalClaimsContract workWork at officeWork from homeWork visaRelocation package$22 - $24 per hour
...of our dedication to winning! The Legal Assistant position is located in our... ...# Draft motions and subpoenas; file claims in CompFile. # Print medical bills, records and other documents as... ...companies and other providers. # Review case files to ensure all tasks are up...MedicalLegalClaimsHourly payWork at office- ...staff is coding at maximum utilization (production coding and/... ...a wide variety of medical records while providing... ...that data complies with legal standards and guidelines... ...-10-CM and CPT codes. Reviews state and federal Medicare reimbursement claims for completeness and accuracy...MedicalLegalClaimsFull timeWork at officeLocal areaRemote work
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