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: $41/hour Job Responsibilities: RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. This position is responsible for performing accurate and timely medical review of claims suspended for medical necessity, contract interpretation, pricing; and to initiate and/or respond to correspondence from providers or members concerning medical determinations. Qualifications: Knowledge of accreditation, i.e., URAC, NCQA standards and health insurance legislation. Awareness of claims processes and claims processing systems. PC proficiency to include Microsoft Word and Excel and health insurance databases. Verbal and written communication skills with the ability to communicate to physicians, members, and providers and compose and explain document findings. Organizational skills and prioritization skills. Registered Nurse (RN) with unrestricted license in the state. 3 years clinical experience. Needs to be able to navigate MCG and medical policies with the reviews. #J-18808-Ljbffr HireOps Staffing, LLC
...Description Job Description NO WEEKENDS/ NO CALLS SALARY: 15$ PER HRS PLUS COMMISSIONS We are seeking a CUSTOMER SERVICES IN THE RADIO to join our team!You will be responsible forhelpingcustomers by providing product and service information and resolvingtechnical...
...United States (US) Hourly/Salaried: Hourly (Non-Exempt) Full Time/Part Time: Full Time Position Type: Regular Your Role at Sephora Asset Protection is constantly evolving to ensure we have products available to delight our clients. Our action-oriented leaders...
The Lexington Police Department currently has several vacant police officer positions. To help fill these openings with high-quality, experienced candidates, the department is hiring retired LPD police officers to rejoin the force via the Sworn Police Officer - R Program...
...Description Job Description Salary: DOE SWLA CENTER FOR HEALTH SERVICES JOB DESCRIPTION JOB TITLE: Licensed Professional Counselor (LPC) DEPARTMENT: Behavioral Health SUPERVISED BY: Behavioral Health Director SUMMARY: provide, oversee, and/or...
Adecco Creative and Marketing partnered with an vehicle parts enterprise to hire a Spanish Copywriter/Editor.**Job Title:** Spanish Copywriter... ...in proofreading/editing.+ Fluency in Spanish+ Strong writing and verbal communication skills.+ Familiarity with storytelling...