Job Tittle: Healthcare - Medical Claim Review Nurse Location: Remote Pay Range: $40.00 - $43.39 Duration: 6 Months... shift within these hours) Performs clinical/medical reviews of retrospective medical claim reviews, medical claims...
, listening. Work requires sitting for extended periods, talking on the telephone, and typing on the computer Nurse Case... to evaluate the medical needs of the member to facilitate the member’s overall wellness. Develops a proactive course of action...
and Responsibilities Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing..., and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member...
clinical necessity that supports the claim in accordance with the respective contract while also coordinating the disposition... of the denied claim with the appropriate personnel. Must demonstrate an understanding of Medicare and other payer...