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....Conduct laboratory experiments using standard and advanced biological techniques (e.g., PCR, Western blotting, cell culture, ELISA,... ...: ~ Bachelors or Masters degree in Biology, Biochemistry, Molecular Biology, or a related field. ~13 years of laboratory research...
...Flexible schedule Training & development Opportunity for advancement Paid time off We are currently hiring active and retired police officers from all departments. Gamma Team Security uses a self scheduling system, in which officers can schedule themselves for...
...Marketing & Call Center Manager at Qualified Applicants summary: The Marketing & Call Center Manager leads multi-channel marketing campaigns and manages customer service operations to drive brand growth and enhance customer experience. This role involves strategic planning...
...digital audiences. A minimum of 3 years of experience in medium-to large markets is preferred, but we will consider all forms of photographer / editing work, not just previous television experience. Your resume and reel should reflect a daily focus on compelling...
...Job Description Job Description Certified Diabetes Educator We are searching for a driven Certified Diabetes Educator to solidify our health promotion efforts. The Certified Diabetes Educator will educate patients on self-management techniques, track treatment adherence...