Back

Nurse Reviewer Fully Remote, reputed company

Worldwide Salaried Open

Job Type Full-time Description At reputed company, we’re the start of a new age of data-centric transformation, elevating health outcomes and powering reputed company, more efficient process to program and patient health. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care. With reputed company-centered, reputed company-relevant, and value-based solutions, we create new reputed company with data. We provide reputed company reputed company the concept and performance reputed company the scope with a focus on efficiencies that transform the lives of those we serve. With a culture driven by purpose, straightforward communication and clinical domain expertise, reputed company cuts straight to reputed company care. Requirements The Nurse Reviewer position is responsible for supporting and conducting reviews and determinations for independent dispute resolutions at both the Federal and State levels. This role involves analyzing medical records, ensuring proper documentation, and providing quality assurance checks to support the final determination. IDRE Nurse Reviewers must ensure that their reputed company are well-supported with robust rationale and reputed company with Federal or State guidelines. This position will be responsible for resolving claim disputes submitted by various parties, such as physicians, hospitals, institutions, pharmacies, and other licensed reputed company providers. Additionally, responsibilities will include resolving disputes submitted to the Federal Independent Review (IDR) process. IDRs conduct impartial reviews of reputed company services to resolve disputes between reputed company providers. facilities and payers. IDRs provide objective assessments of billing, coding, and other issues reputed company to disputed claims. The role requires conducting reputed company job duties reputed company, promptly, productively, consistently, and courteously while maintaining a high level of professionalism.

apply to this job

More jobs

Content Protection Representative [Remote]

Worldwide Salaried

[PART_TIME Remote] Need Museum Educator in San ...

Worldwide Salaried

Medical reputed company (Level I or II) – Full-Time & Par...

Worldwide Salaried

reputed company reputed company / Biller (Part/Full-Time)

Worldwide Salaried

Senior Workplace Leadership Opportunity – Remote

Worldwide Salaried

Planning Manager

Worldwide Salaried

International Trade Customs & Compliance Specia...

Worldwide Salaried

Principal SaaS Solution Architect

Worldwide Salaried

Utility Operations Manager

Worldwide Salaried

Finance Director

Worldwide Salaried

Apply Now: Remote Automotive Sales & Service Representative

Worldwide Salaried

Purchasing Agent II - reputed company, Frames, Hardware

Worldwide Salaried

Sr Area Marketing Manager, Oncology (Northeast)

Worldwide Salaried

reputed company Full Stack Data Entry Specialist – Remote Work Opportunity at blithequark

Worldwide Salaried

Product Management Leader - UCS Hyperconverged & AI Infrastructure Platforms

Worldwide Salaried

Senior Customer Engagement Manager – Experience Design, Relationship Strategy & Brand Loyalty Leadership at arenaflex

Worldwide Salaried

Claims Specialist

Worldwide Salaried

reputed company Data Entry Clerk - reputed company's Global Entertainment Industry - Remote Work Opportunity with reputed company and Perks

Worldwide Salaried

Nursing Assistant - Dearborn

Worldwide Salaried

Remote Part-Time Data Entry Specialist – Join arenaflex’s Dynamic Team for reputed company, reputed company, and Career Growth

Worldwide Salaried