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. HireOps Staffing LLC
Join our team as a CT Technologist and enjoy a $5,000 sign-on bonus or Student Loan Payment Program! Perform high-quality radiologic and CT exams, monitoring patient well-being and administering contrast safely. Provide compassionate guidance to patients,...
...Hi, I'm currently partnered with a investment firm based in Charlotte, NC who are seeking an experienced Senior Analyst with 3+ years of hedge fund due diligence experience in private markets. This is a fantastic opportunity to join a small, high-energy team, where...
...PRIDE Health is seeking a travel nurse RN Clinic Labor and Delivery for a travel nursing job in Visalia, California. Job Description & Requirements ~ Specialty: Labor and Delivery ~ Discipline: RN ~ Start Date: 06/30/2025~ Duration: 13 weeks ~36 hours per...
Job Description: IndustrialFirefighter/Paramedic Citgo Petroleum Refinery , Lemont, IL *$4,000 sign on bonus for Industrial Firefighter EMT FT employees* IMMEDIATELY HIRING! FULL-TIMEOpportunity Sa lary: $70,453.00 annual estimate (position...
...Description Introduction Want to join a team of daring managers who care without reservations or limits? Our Belton Regional Medical Center team is looking for a(an) RN Nursing Manager Medical Telemetry. HCA Healthcare is an advanced healthcare network that has...