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
...s annual budget stands at $1.85 billion, and its endowment totals nearly $1.8 billion. Job Overview The Department of Aerospace Engineering and Engineering Mechanics (AEEM) in the College of Engineering and Applied Science (CEAS) at the University of Cincinnati (UC...
...x Rinnai Pro Council Member 2023- 2025~6 x Daikin / Amana / Hvac Distributor Dealer Awards 2018 - 2024 Here at SUREWAY ,... ...Journeyman or Master Plumber license (ACHD) OR be willing to attend apprentice school to gain a license Prior residential service...
...~ Training & development ~ Vision insurance ~ Wellness resources Individuals with previous experience operating a remote controlled Overhead Crane in a steel service center or fabrication environment. Responsible for operating an overhead crane to lift, move...
...ManTech seeks a Cloud Software Engineer to join our team in the Ft. Meade, MD area . In this role, you will develop, maintain, and enhance complex and diverse Big-Data cloud systems based upon documented requirements. Responsibilities include, but are not limited...
...Job Posting: Talent Agent at Rewired Talent Management Location: Remote (Los Angeles, CA) *MUST RESIDE IN THE LOS ANGELES SURROUNDING AREA About Us: At Rewired Talent Management, we are a dynamic talent management company dedicated to representing and nurturing...