Utilization Review Nurse — Appeals & Medical Claims
$29.05 - $67.97 per hourMolina Healthcare of Illinois
Molina Healthcare in Salt Lake City, Utah, is seeking a Registered Nurse with at least 2 years of clinical nursing experience. The role involves reviewing documentation for medical necessity, managing claims, and working on appeals for prior authorizations. Ideal candidates should demonstrate knowledge in ICD-10 coding and possess strong analytic and communication skills. The position offers a competitive hourly wage ranging from $29.05 to $67.97, depending on qualifications and experience. #J-18808-Ljbffr Molina Healthcare
$29.05 - $67.97 per hour
...Description Job Summary Utilizing clinical knowledge... ..., responsible for review of documentation to ensure medical necessity and... ...medical record and claim submitted support correct... ...review of appeals for denied prior authorizations... ...2 years clinical nursing experience,...MedicalClaimsHourly payWork experience placementWork at office$29.05 - $67.97 per hour
...Description Job Summary Utilizing clinical knowledge... ..., responsible for review of documentation to ensure medical necessity and... ...medical record and claim submitted support... ...concurrent review of appeals for denied prior... ...least 2 years clinical nursing experience,...MedicalClaimsHourly payWork experience placementWork at office- Surgery Partners, Inc is looking for a dedicated candidate to handle medical claims in the health care industry. Responsibilities include working on denials, appeals, following up on unpaid claims, and contacting insurance companies. The ideal candidate will have a high...MedicalClaims
- AR Specialist General Summary Of Duties Working denials, appeals, and aging report. Following up on medical claims that have not been paid timely. Contacting insurance companies to see why claims have not been processed, sending medical records, contacting patients regarding...MedicalClaimsLocal area
- ...Clinical Appeals Reviewer (Licensed Healthcare Professional... ...limited to Registered Nurses (RN), Physical... ...Responsibilities Reviews medical records/case files,... ...Medicare regulations, claims processing, and the medical... ...care appeals or utilization management activities...MedicalClaimsFull timeContract workPart timeFor contractorsWork at officeLocal areaRemote workNight shift
$246.1k - $344.2k
...part of our caring community The Corporate Medical Director relies on medical background and reviews health claims. You will work on problems of diverse scope and... ...timely, and defensible medical decisions on complex appeal cases, exercising professional judgment with...MedicalClaimsBi-weekly payFull timeTemporary workApprenticeshipInterim roleWork at officeRemote workWork from homeHome officeMonday to Friday$75k - $105k
...Job Description Workers' Compensation Claims Adjuster Job Summary Looking... ...and occupational-disease claims. Reviewing medical records and other documentation to manage... ...closely with the Workers' Compensation Appeals Board and judges as needed. Qualifications...MedicalClaims- ...maximum reimbursement. # Work aged accounts, process appeals and corrected claims, research and reconcile credit balance accounts, and process... ...required. #3+ years of experience working in medical billing or revenue cycle. # Proven track record of high...MedicalClaims
$72.91k - $95k
...Financial Services & Insurance Claims Team Lead - Workers... ...claims adjudication. Compiles reviews and analyzes management reports... ...standards. Acts as second level of appeal for client and claimant issues... ...including but not limited to, medical, dental, vision, 401k and matching...MedicalClaimsContract workWork at officeLocal areaFlexible hours- ...ID Cards and Certificates of Insurance, Claims Reporting and Instructions, Loss Runs and... ...Performance Bonus, Stock Purchase, Medical Plans, Prescription Drugs, Dental, Vision... ...business model that makes working at IMA so appealing. We work in teams. We sell in teams....MedicalClaimsTemporary workInternshipLocal areaFlexible hours
$18 - $22 per hour
...JQ Medical Supply, a leading provider of durable medical equipment... ...The individual oversees that claims are processed accurately, timely... ...discrepancies. Investigate and appeal denied claims, working with... ...of claims for all payers. Review and resolve complex billing issues...MedicalClaimsHourly pay- ...Patient Accounts Representative II The Medical Claims & Appeals Analyst is responsible for researching, resolving, and appealing outstanding medical claims to maximize reimbursement and reduce accounts receivable. This role involves monitoring assigned accounts, identifying...MedicalClaims
$18.3 per hour
...Medical Billing Representative I Schedule: Monday - Friday (40 hrs... ..., including billing, claims management, and client communication... ...follow-up, and collection). Review Aged Trial Balance (ATB) report... ...resubmit them for payment or appeal. Submit and follow-up on prior...MedicalClaimsHourly payFull timeWork at officeMonday to Friday$100 per hour
...Medical Billing Rep II Schedule: Monday - Friday (40 hrs/wk) 8:0... ...departments, including billing, claims management, and client... ...assigned accounts. Prepare and review the Aged Trial Balance (ATB) report... ...resubmit them for payment or appeal. Submit and follow-up on...MedicalClaimsWork at officeMonday to Friday$20 - $22 per hour
...referrals Describing required authorizations for medical care Assisting with claims' issues Providing claims' status Answering... ...calls without consulting the Unit Leader. Prepare appeals for Unit Leader review. Level III - Level I and II skills, plus complete...MedicalClaimsHourly payFull timeTemporary workWork at officeMonday to Friday$19.39 per hour
...center services. Serves as first line reviewer in monitoring and ensuring adherence... ...oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing... ...pharmacy representative in onsite member appeals and grievances sessions. Serve as...MedicalClaimsFor contractorsLocal area$191.15k - $305.85k
...Job Description The Medical Director brings a unique set of... ...groups, and members as needed. Utilizes clinical knowledge and experience... ..., case management, PA, appeals) Healthcare programs (disease... ..., and internet sites claiming to represent Blue Cross and Blue...MedicalClaimsLocal areaRemote work- ...renewal with the Producer (policy review, setting the game plan, loss... ...Bonus, Stock Purchase, Medical Plans, Prescription Drugs, Dental... ...competitive benefits, plus claim part ownership? It's this unique... ...that makes working at IMA so appealing. We work in teams. We sell...MedicalClaimsTemporary workInternshipLocal areaFlexible hours
$90k - $112.76k
...hospitals, health systems and medical groups. We are the one company... ...stages of the administrative appeals process. Every day, you will handle contract review and appeal template development... ...language and rates to resolve denied claims. Utilize payer-provider and...MedicalClaimsContract workLocal area$23 - $25 per hour
...DUTIES AND RESPONSIBILITIES Review patient bills for accuracy and... ...Prepare, review, and transmit claims using billing software, including... ...follow‑up. Research and appeal denied claims. Submit claims... ...two years of experience in a medical office setting and at least one...MedicalClaimsHourly payFull timeWork at office- ...Claims Specialist Department: Advocacy Overview: GBS Benefits, Inc. is the... ...Investigate and resolve denied or complex medical and pharmacy claims. ~ Analyze Explanation... ...yourself and clients and know when to utilize other GBS departments. ~ Must be...MedicalClaimsWork at office
- ...benefits, including top-tier medical plans and tuition support set... ...Maintains cleanliness and eye-appeal of work area, storage area,... ...clearly and professionally, utilizing excellent verbal, written and... ...authenticity of any communication claiming to be from WinCo by checking...MedicalClaimsImmediate startShift workNight shift
$20.02 - $25.78 per hour
...processes that healthcare providers utilize to capture, bill, and collect... ...Responsibilities Submitting medical documentation/billing data to insurance... ...providers Researching and appealing denied and rejected claims Preparing, reviewing, and transmitting claims using...MedicalClaimsHourly payTemporary workWork experience placementLocal areaImmediate startRemote workFlexible hours$100k
...Refinancing: As low as 2.99% Insurance: Comprehensive medical, dental, vision, and Rx coverage Disability: Short- and long... ...including tail and free litigation support. USACS malpractice claims are less than 1/2 the national average! Intangible BenefitW-2...MedicalClaimsFull timeTemporary workLocal areaShift work$85k - $110k
Sedgwick is seeking a Claims Team Lead to supervise multiple teams for liability claims. The role involves providing technical direction... ...of $85,000 - $110,000 per year and a comprehensive benefits package, including medical, dental, and 401k matching. #J-18808-LjbffrMedicalClaimsRemote work$100k
...Refinancing: As low as 2.99% Insurance: Comprehensive medical, dental, vision, and Rx coverage Disability: Short- and long... ...including tail and free litigation support. USACS malpractice claims are less than 1/2 the national average! Intangible BenefitW-2...MedicalClaimsFull timeTemporary workLive inLocal areaShift work$100k
...~ Student loan refinancing as low as 2.99% ~ Comprehensive medical, dental, vision and Rx coverage ~ Short- and long-term disability... ...tail and free litigation support ~ USACS malpractice claims are less than 1/2 the national average! Intangible Benefits...MedicalClaimsFull timeTemporary workLocal areaShift work$23 - $27 per hour
...payor guidelines Coordinate, review, and analyze documentation and... ...Reimbursement on progress of claims and follow up status Submit... ...Prepare/review and submit appeal information as needed to payor... ...Microsoft Office applications Medical Billing Certificate preferred...MedicalClaimsHourly payFull timeWork at officeLocal areaRemote workShift work- ...is the management company for Alpine Home Medical, Copper Star Home Medical Supplies and... ...We are currently seeking Medical Billing/Claims Specialist who will be responsible for billing... ...and resubmission criteria, and medical reviews. Performing any other duties as deemed...MedicalClaimsWork at office
- ...Granger Medical Clinic is hiring a Full Time CPC CERTIFIED Medical Coder, fully remote. Applicants must reside in specific states including Utah. This role involves auditing and coding E & M visits, providing feedback to providers, and maintaining high coding accuracy....MedicalClaimsFull timeRemote work
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