Title: Utilization Review Nurse Location: Fully Remote must reside in - TX/IL Duration: 6 months Contract (Possible Extension) Schedule: Monday – Friday, 8:00 AM – 5:00 PM Pay Rate : $40/hr - $41/hr on W2 Job Description: RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. This Position Is Responsible for Performing Accurate and Timely Medical Review of Claims Suspended for Medical Necessity, Contract Interpretation, Pricing; And to Initiate And/or Respond to Correspondence from Providers or Members Concerning Medical Determinations. Knowledge of accreditation, i.e., URAC, NCQA standards and health insurance legislation. Awareness of claims processes and claims processing systems. PC proficiency to include Microsoft Word and Excel and health insurance databases. Verbal and written communication skills with ability to communicate to physicians, members and providers and compose and explain document findings. Organizational skills and prioritization skills. :Registered Nurse (RN) with unrestricted license in state. 3 years clinical experience.aa415a4b-8b21-40fc-a65c-70d2b25ca29a
...Category: Claims Description Join us as a Field Property Claims Adjuster where you'll be responsible for helping our customers navigate... ...The Field Property Claims Adjuster will be traveling locally to insured homes within Tucson, AZ (85745) and surrounding areas. To be...
...estimated yearly salary ranging from $182,000 to $234,000. Why Choose This Opportunity? If you're seeking a career with excellent weekly pay, a steady schedule, and reliable freight that keeps you on the go, look no further. We are looking for Class A CDL Owner Operators...
...Position Title: Temporary HR Generalist / HRIS Specialist Wage: $28.00-$29.00 per hour Hours: 7:00am-5:00pm (Mon-Fri 1-2 days required... ...day-to-day HR activities such as employee data changes, onboarding support, job changes, and responding to basic employee inquiries...
...LinkedIn and Tik Tok . Job Description "This role is field-based, and candidates should live within a reasonable... ...cities: Norfolk Virginia Beach Richmond The Field Reimbursement Manager, Botox Therapeutic (FRM) acts as an alternative in-office...
...Accountable for collection of COD accounts. Reports all accidents to Driver Supervisor immediately. Logs break, lunch times and follows route on trip sheet. Able to demonstrate regular and reliable attendance. Able to work overtime as required. Other duties as...