South Carolina Licensed RN Reviewer
VirtualVocationsMilwaukee, Wisconsin, United States21 hours ago
Job type
- Full-time
Job description
A company is looking for an RN Medical Reviewer II to perform medical reviews and support medical claims processing.
Key Responsibilities
Conduct medical claim reviews for complex services and determine coverage and reimbursement based on established criteria
Document medical rationale for payment or denial of services and provide education on medical reviews and coding procedures
Participate in quality control activities and assist with special projects as assigned by management
Required Qualifications, Training, and Education
Associate Degree in Nursing or graduate of an accredited School of Nursing
Two years of clinical experience
Active RN licensure in the state hired or an active compact multistate RN license
Preferred experience in medical review or utilization review
Proficient in Microsoft Office
Create a job alert for this search
South Carolina • Milwaukee, Wisconsin, United States
Related jobs
Patient Experience Coordinator.At Aspen Dental, we put You first, offering the security and job stability that comes with working with a world-class dental service organization (DSO).Our best-in-cl...Show moreLast updated: 30+ days ago
With a mantra of Empowering Human Potential, Hanger, Inc.O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service.Ha...Show moreLast updated: 4 days ago
At Children's Wisconsin, we believe kids deserve the best.Our pediatricians and primary care offices offer parents a level of care that cannot be obtained at other places : .Affiliation with the #4 c...Show moreLast updated: 30+ days ago
Our agency is currently hiring a Medical Billing Specialist for a client in Milwaukee.Medical Billing & A / R Specialist.
Required Minimum Position Qualifications : .Medical Billing / Coding Certifica...Show moreLast updated: 30+ days ago
Patient Access Specialist - Clinic.Patient Access Specialist Responsibilities : .A Patient Access Specialist serves as the first point of contact for Froedtert South.
The position is accountable for a...Show moreLast updated: 30+ days ago Children's Wisconsin Front Desk Team Member.At Children's Wisconsin, we believe kids deserve the best.Our pediatricians and primary care offices offer parents a level of care that cannot be obtaine...Show moreLast updated: 30+ days ago 
Patient Service Representative.Come join our team! We have an immediate need for a Patient Service Representative in our Racine, WI clinic! If you are ready to make an impact every day, and thrive ...Show moreLast updated: 30+ days ago
Our hospital provides high-quality care that transforms the lives of those living with disabling injuries and illnesses.We distinguish ourselves through our commitment to excellence, to our patient...Show moreLast updated: 5 hours ago
Medical Coder Job Duties : Accounts for coding and abstracting of patient encounters, includ...Show moreLast updated: 30+ days ago
A Patient Access Specialist serves as the first point of contact for Froedtert South.The position is accountable for appointment scheduling, patient check-in and check-out, registration, coverage m...Show moreLast updated: 25 days ago
Headquartered in Chicago, RISING Medical Solutions is a privately held, financial solutions organization offering medical cost containment and care management services.
With offices, providers, and ...Show moreLast updated: 6 days ago Patient Access Specialist Responsibilities : .A Patient Access Specialist serves as the first point of contact for Froedtert South.
The position is accountable for appointment scheduling, patient chec...Show moreLast updated: 12 days ago 
American Family Care (AFC) is one of the largest primary and urgent care companies in the U.Our state-of-the-art centers focus on the episodic treatment of acute illnesses and injuries, workers' co...Show moreLast updated: 30+ days ago
Customer Service Representative.R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical gr...Show moreLast updated: 30+ days ago At Children's Wisconsin, we believe kids deserve the best.Children's Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children.We provide primary ...Show moreLast updated: 30+ days ago 
SIGN ON BONUS FOR EXTERNAL APPLICANTS.Explore opportunities with Optum.ProHealth Care is proud to be a leader in health care services, serving Waukesha County and the surrounding areas for more tha...Show moreLast updated: 7 hours ago Position : Certified Medical Assistant.Schedule : M, Wed and Fri from 8 am to 5, Tues, 10 am to 7 pm.If interested, please send updated resume, hs diploma and MA certification to : .Please call me at 2...Show moreLast updated: 30+ days ago 
Our hospital provides high-quality care that transforms the lives of those living with disabling injuries and illnesses.We distinguish ourselves through our commitment to excellence, to our patient...Show moreLast updated: 8 hours ago
The Patient Access Representative (Registration Representative) supports the patient intake and billing processes by ensuring accurate and complete registration, referral management, insurance veri...Show moreLast updated: 30+ days ago
Explore Opportunities With Optum.SIGN ON BONUS FOR EXTERNAL APPLICANTS.Explore opportunities with Optum, in strategic partnership with ProHealth Care.
ProHealth Care is proud to be a leader in healt...Show moreLast updated: 7 days ago
- Promoted
Patient Coordinator
Aspen DentalBrookfield, WI, USFull-time
- Promoted
Patient Access Coordinator
HangerWaukesha, WI, USFull-time
- Promoted
Clinic Service Rep - Forest Home
Children's WisconsinMilwaukee, WI, USFull-time
- Promoted
Medical Billing Specialist / $20 an hour
All Medical AlliedMilwaukee, WI, USFull-time
Patient Access Specialist - Clinic
Froedtert South, Inc.Pleasant Prairie, Wisconsin, United States, 53158Full-time
- Promoted
Clinic Svc Rep
Children's WisconsinMilwaukee, WI, USFull-time
- Promoted
Patient Service Representative
My Derm RecruiterRacine, WI, USFull-time
- Promoted
- New!
Clinical Liaison (Milwaukee)
ClearSky HealthMilwaukee, WI, USPart-time
- Promoted
Medical Coder
TradeJobsWorkForce53167 Rochester, WI, USFull-time
- Promoted
Patient Access Representative
Aya HealthcareKenosha, WI, USFull-time
- Promoted
Specialty Medical Bill Review Auditor
Rising Medical SolutionsMilwaukee, WI, USFull-time
Patient Access Specialist
Froedtert South, Inc.Kenosha, Wisconsin, United States, 53143Full-time
- Promoted
PRN Medical Receptionist
American Family CareKenosha, WI, USFull-time
- Promoted
Customer Service Representative - Patient Registration
R1 RCMRacine, WI, USFull-time
- Promoted
Mgr Provider Coding Audit
Children's WisconsinMilwaukee, WI, USFull-time
- Promoted
- New!
Patient Access Team Lead
OptumSUSSEX, WI, United StatesFull-time +1
- Promoted
Certified Medical Assistant - Waukesha, WI
All Medical AlliedWaukesha, WI, USFull-time
- Promoted
- New!
Clinical Liaison
ClearSky HealthMilwaukee, WI, United StatesFull-time
- Promoted
Patient Access Representative
NovirMilwaukee, WI, USFull-time
- Promoted
Part Time Patient Access Registration Representative
UnitedHealth GroupWaukesha, WI, USFull-time +1