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Search Results for ' Medical Claims Review Nurse in U.S. National Average, USA '

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Medical Claims Review Nurse
Resolves, audits, and processes claims for clinically related issues to ensure accuracy of claims payment, supporting the Claims Administration Department. Maintains contact with community hospitals and providers, reviewing, processing, and auditing claims for payment and appropriateness of charges and pursues... [+] More
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Utilization Review Director
Coordinates and supervises all phases of Utilization Review and Social Services. Plans and directs the operational activities of the Utilization Review and Social Services Departments, assuming responsibilities for quality and productivity of utilization review and discharge planning.

Coordinates, facilitates, and integrates... [+] More
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Utilization Review Manager
Manages the utilization review function to ensure accurate and timely prior authorization of designated healthcare services, concurrent review, and retrospective review activity. Performs regular data analysis of hospital census, authorization information and medical cost reports to identify variances and root... [+] More
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Utilization Review/Quality Assurance Director
Serves as an information coordinator for the hospital-wide quality assurance program. Directs development of monitors, including generic screens, to assess the quality of care provided to patients.

Supports the overall quality assurance reporting system to assure that information is being channeled... [+] More
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Critical Care Unit Nurse (CCU Nurse)
Treats and provides nursing care to Critical Care Unit patients in hospital or similar health care facility. Readies equipment and aids physician during treatments and examinations of patients. Administers prescribed medications and treatments in accordance with approved nursing techniques. Observes... [+] More
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Neonatal Intensive Care Unit Nurse (NICU Nurse)
Manages the care of neonatal patients resulting from the childbearing process that requires moderate to complex assessments, interventions, and level of nursing vigilance. Provides tertiary and quaternary care to premature infants and newborns. Works with critically ill neonates with life-threatening... [+] More
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Obstetrics Nurse (OB Nurse)
Treats and provides professional nursing care to patients in the obstetrical and gynecological departments. Administers prescribed medications and total patient care in the labor room, delivery room, postpartum unit, and nursery. Requires RN license.

Maintains patients' medical records. Aids physician during treatments, examinations, and surgical procedures. Evaluates, plans, and documents the delivery room nursing process as needed.
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Utilization Review Supervisor
Plans, organizes, and supervises, under general direction, the activities of the Utilization Review unit of a hospital. Ensures compliance with reimbursement rules of third-party payers. Performs the more complex utilization review work. Monitors and ensures hospital compliance with Medic-Cal, Medicare,... [+] More
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Utilization Review Coordinator
Analyzes and evaluates patients' medical records, charts, computer printouts, and support documents to ensure criteria for admission to health-care facility, treatment, and length of stay are met, and to ensure cost effective utilization of resources, according to established criteria

Analyzes insurance,... [+] More
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Medical Claims Review Manager
Manages the medical claims review... [+] More
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