Remote position, however, candidates must reside in the State of TX or State of IL
This position is a contract for about 9 months. Pay: $41/hour 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. Needs to be able to navigate MCG and Medical policies with the reviews....Today! Are you eager to earn extra income from the comfort of your home? We are looking for motivated individuals to participate in paid... ...is for you. Why Choose Us? You have the flexibility to work either from home or in-person, with the option to choose what suits...
...Scrum Master Opportunity NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We have a Scrum Master available for six months...
...Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management, Quality Screening and Delay Management for assigned... ...based on Departmental standards. While performing utilization review identifies areas for clinical documentation improvement and...
...Job Description Job Description Seeking an experienced Driving Instructor to be responsible for preparing students to take to the road safely, including teaching the rules and regulations of the road, has excellent communication and interpersonal skills. This position...
...Licensed Practical Nurse (LPN)Women's Health | Full-Time | No Weekends | $20+/hr Location: Little Rock, AR Are you a compassionate... ...) Previous experience in women's health, family practice or hospital (strongly preferred) Working knowledge of clinical procedures...