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Medical review nurse jobs

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A-Line Staffing Solutions

 ...WHAT YOU'LL DO: Primarily perform telephonic review request of medical claims for appropriateness of therapy, coding, and review medical necessity...  ...and placed mechanisms to meet those needs. REGISTERED NURSE QUALIFICATIONS: Active Unrestricted RN or LPN License in... 
4 hours ago
Charlotte, NC

Integrated Resources, Inc

 ...Excel test   5 Months (Starts Jan 27 th ) Onsite: Jacksonville FL (NO REMOTE)   General Information The Quality HEDIS Medical Review Nurse performs medical record reviews, abstract HEDIS data according to the HEDIS Technical Specifications to include over-reads.... 
1 day ago
Jacksonville, FL

Integrated Resources, Inc

Job Description: Active Florida Nursing License with two (2) years of related work experience Must have previous medical record / quality review experience; HEDIS/STARS preferred Must be proficient in Microsoft Office (Word, Excel, Outlook, and PowerPoint) as well... 
26 days ago
Jacksonville, FL

Integrated Resources, Inc

 ...Job Title: Medical Review Nurse - LPN Location: Remote Duration: 3+ months   Job Summary: The Medical Review Nurse LPN reviews, authorizes, coordinates, and responds to requests for services for Client members. This position also communicates telephonically... 
18 days ago
Jacksonville, FL


 ...Medically Managed Bill Review Nurse The Medically Managed Bill Review Nurse is responsible for retrospective utilization management activities per specified state bill review guidelines and Bunch bill review protocols. He/she is responsible for the audit of complex... 
2 days ago
Lakeland, FL

w3r Consulting

 ...Job Description   Job Requirements · Active Florida Nursing License with two (2) years of related work experience* Knowledge of medical terminology · Experience with medical record/quality review experience. HEDIS/Stars preferred · Experience applying nationally... 
2 days ago
Jacksonville, FL


Medical Review Nurse Position Purpose: Perform medical review provider claims, authorizations, and medical records to achieve resolution of authorization issues that result in claims denials or pended claims. Perform retrospective review for medical necessity appeals... 
15 days ago
Baton Rouge, LA


SunIRef:Nurse:title Medical Record Review Nurse Lumeris 53 reviews - St. Louis, MO Lumeris 53 reviews Read what people are saying about working here. In order to apply for a position at Lumeris, you must create an account using your email address and a... 
7 days ago
Saint Louis, MO


A consulting company has a current position open for a Telecommute Medical Review Nurse.Must be able to: Conduct medical record reviewsApply sound clinical judgment to claim payment decisionsSupport ongoing fraud investigations and requests for informationRequired Skills... 
2 days ago
Savannah, GA


 ...Job Duties:Perform clinical auditsWork closely with Medical Director for quality driven clinical...  ...other duties as assigned by management• Registered nurse with at least 10 years' experience; utilization review/case management experience helpful• Bachelor's Degree... 
3 days ago
Pittsford, NY


Medliminal is the leading edge of medical cost containment and we are always looking for amazing...  ...Summary:Medliminal is seeking Licensed Nurses to join our Hospital Compliance Division...  ...and accurate charges. Duties include review of UB-04 forms, detailed/itemized statements... 
4 days ago
Manassas, VA


A consulting company is seeking a Remote Medical Review Nurse in Sunrise. Core Responsibilities Include: Auditing claims for medically appropriate services Applying appropriate medical review guidelines, policies and rules Documenting all findings Qualifications for this... 
5 days ago
Lakeland, FL


A consulting company is seeking a Remote Medical Review Nurse in Sunrise.Core Responsibilities Include: Auditing claims for medically appropriate servicesApplying appropriate medical review guidelines, policies and rulesDocumenting all findingsQualifications for this position... 
17 hours ago
Naples, FL

Compunnel Inc.

$32 per hour
 ...members in the Acute Hospital, LTAC, Acute Inpatient Rehab and/or Skilled Nursing Facility for benefit determination, medical necessity and appropriate level of care  Participate in weekly case review  Plan, implement, coordinate and monitor care coordination... 
12 days ago
Jacksonville, FL


 ...Aerotek Scientific is seeking Medical Review Nurse for temporary position for various organizations in the Jacksonville, FL area. This position includes competitive salary and benefits. MINIMUM QUALIFICATIONS Current RN, LPN, or LVN license in state of Florida... 
5 hours ago
Jacksonville, FL

VITAS Healthcare

 ...of life care. We provide our employees opportunities for professional growth, advancement and competitive benefits.  The Medical Records Reviewer is responsible for record review and data entry into PIS system . Handles customer service calls for telecare services.... 
2 days ago
Eustis, FL

Three Point Solutions

 ...Job Description Medical Review Analyst (MRA) Key Performance Indicators: Excellent multi-tasking skills Prioritization and organization skills Strong analytical skills Key Duties/Responsibilities: Coordinates activities, updates process, maintains... 
7 days ago
Fargo, ND


Medical Coding Reviewer I USA-Missouri-Chesterfield Position Purpose: Perform clinical/coding medical claim review to ensure compliance...  ...national origin, disability, veteran status, or other characteristic protected by applicable law. Clinical & Nursing Full-time
5 days ago
Chesterfield, MO

Adecco Staffing

A Medical Review Associate job in Charlotte, NC is available courtesy of Adecco Medical & Science. You will be part of the Medical Review...  ...receive training on that as well. Qualifications Looking for Nursing candidates or Paralegals who have a medical specialization. Prefer... 
5 days ago
Charlotte, NC

BlueCross BlueShield of South Carolina

SummaryResponsible for the supervision and maintenance of the daily functions of Utilization Review/Review Nurses, Case Management, and/or Medical Review staff and specialty programs. Ensures appropriate levels of healthcare services are provided.Description* 60% Manages... 
1 day ago
Columbia, SC