Nurse Reviewer I
2 weeks ago
Zelis is seeking a skilled Nurse Reviewer I to join our team. As a key member of our revenue cycle team, you will be responsible for conducting thorough reviews of healthcare claims to ensure accuracy and compliance with industry guidelines.
Key Responsibilities- Conduct in-depth reviews of healthcare claims to identify potential errors or discrepancies
- Apply clinical knowledge and expertise to evaluate medical records and coding practices
- Collaborate with cross-functional teams to resolve claim issues and improve revenue cycle efficiency
- Stay up-to-date with industry developments and regulatory changes to ensure compliance
- Develop and maintain strong relationships with healthcare providers and payers
- 3-5 years of experience in healthcare claims review, auditing, or a related field
- Strong clinical knowledge and expertise in medical coding and billing
- Excellent analytical and problem-solving skills
- Ability to work independently and as part of a team
- Strong communication and interpersonal skills
- A dynamic and supportive work environment
- Opportunities for professional growth and development
- A competitive salary and benefits package
- A chance to work with a leading healthcare technology company
Zelis is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive and respectful work environment that values diversity, equity, and inclusion.
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Nurse Reviewer I
2 weeks ago
Atlanta, Georgia, United States Zelis Full timeJob Title: Nurse Reviewer IZelis is seeking a highly skilled Nurse Reviewer I to join our team. As a key member of our revenue cycle team, you will be responsible for conducting thorough reviews of healthcare claims to ensure accuracy and compliance with industry guidelines.Key Responsibilities:Conduct in-depth reviews of healthcare claims to identify...
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Nurse Reviewer I
2 weeks ago
Atlanta, Georgia, United States Zelis Full timeJob SummaryZelis is seeking a skilled Nurse Reviewer I to join our team. As a key member of our revenue cycle team, you will be responsible for conducting thorough reviews of healthcare claims to ensure accuracy and compliance with industry guidelines.Key ResponsibilitiesConduct in-depth reviews of healthcare claims to identify potential errors or...
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Nurse Reviewer I
2 weeks ago
Atlanta, Georgia, United States Zelis Full timeJob SummaryZelis is seeking a skilled Nurse Reviewer I to join our team. As a key member of our healthcare financial experience team, you will play a critical role in modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers.Key...
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Nurse Reviewer I
2 weeks ago
Atlanta, Georgia, United States Zelis Full timeJob SummaryZelis is seeking a skilled Nurse Reviewer I to join our team. As a key member of our healthcare financial experience team, you will play a critical role in modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers.Key...
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Medical Necessity Reviewer
4 weeks ago
Atlanta, Georgia, United States Piedmont Healthcare Corporate Full timeJob SummaryPiedmont Healthcare Corporate is seeking a skilled Clinical Appeals Specialist to join our team. As a key member of our appeals process, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key ResponsibilitiesConduct detailed reviews of...
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Medical Necessity Reviewer
4 weeks ago
Atlanta, Georgia, United States Piedmont Healthcare Corporate Full timeAbout the Role:Piedmont Healthcare Corporate is seeking a skilled Clinical Appeals Specialist to join our team. As a key member of our appeals process, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key Responsibilities:Conduct detailed...
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Medical Necessity Reviewer
4 weeks ago
Atlanta, Georgia, United States Piedmont Full timeJob Summary:Piedmont is seeking a highly skilled Clinical Appeals Specialist to join our team. As a Clinical Appeals Specialist, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key Responsibilities:Conduct detailed reviews of patient medical...
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Utilization Review Nurse
2 days ago
Atlanta, Georgia, United States Sonder Health Plans Full timeJob Title: Utilization Review NurseAt Sonder Health Plans, we are seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will play a critical role in ensuring that healthcare services are administered with quality, cost efficiency, and within compliance.Key Responsibilities:Conduct concurrent reviews of member...
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Utilization Review Nurse Specialist
2 days ago
Atlanta, Georgia, United States Children's Healthcare of Atlanta Full timeJob SummaryWe are seeking a skilled Utilization Review Nurse to join our team at Children's Healthcare of Atlanta. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the most appropriate level of care while minimizing unnecessary costs.Key ResponsibilitiesConduct pre-screening assessments of prospective patients to...
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Utilization Review Nurse Specialist
2 weeks ago
Atlanta, Georgia, United States Children's Healthcare of Atlanta Full timeJob SummaryWe are seeking a skilled Utilization Review Nurse to join our team at Children's Healthcare of Atlanta. As a key member of our multidisciplinary team, you will play a critical role in ensuring the efficient and effective delivery of healthcare services to our patients.ResponsibilitiesParticipate in pre-screening assessments of prospective patients...
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Utilization Review Nurse Specialist
2 weeks ago
Atlanta, Georgia, United States Children's Healthcare of Atlanta Full timeJob SummaryWe are seeking a skilled Utilization Review Nurse to join our team at Children's Healthcare of Atlanta. As a key member of our multidisciplinary team, you will play a critical role in ensuring the efficient and effective delivery of healthcare services to our patients.ResponsibilitiesParticipate in pre-screening assessments of prospective patients...
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Quality Assurance Nurse Reviewer
3 days ago
Atlanta, Georgia, United States Spectraforce Technologies Inc Full timeJob Title: Quality Assurance Nurse ReviewerJob Description:The Quality Assurance Nurse Reviewer will work under the direction of the HEDIS Quality Assurance Team Lead and other company personnel to perform quality assurance reviews on medical records.The candidate will validate abstracted medical record data and enter findings electronically into a specified...
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Utilization Review Nurse Specialist
3 weeks ago
Atlanta, Georgia, United States Sonder Health Plans Full timeJob Description:The Utilization Review Nurse role at Sonder Health Plans is a critical position that ensures healthcare services are administered with quality, cost efficiency, and within compliance.Key Responsibilities:Conduct concurrent reviews of members' clinical information to ensure efficiency and effectiveness of care.Review preauthorization requests...
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Medical Review Nurse
3 weeks ago
Atlanta, Georgia, United States Pyramid Consulting, Inc Full timeJob Opportunity: Medical Review Nurse - RNAbout the Role:We are seeking a talented Medical Review Nurse - RN to join our team at Pyramid Consulting, Inc. This is a 02+ Months Contract opportunity with long-term potential.Key Responsibilities:Conduct thorough medical reviews of patient records to ensure accuracy and qualityCollaborate with healthcare...
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Medical Record Reviewer
4 weeks ago
Atlanta, Georgia, United States Spectraforce Technologies Full timeJob Title: HEDIS Nurse Abstractor SpecialistJob Summary:Spectraforce Technologies is seeking a highly skilled HEDIS Nurse Abstractor Specialist to join our team. As a HEDIS Nurse Abstractor Specialist, you will be responsible for reviewing medical records, abstracting pertinent data, and entering it into a specified database to support HEDIS reporting.Key...
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Utilization Review Nurse
4 weeks ago
Atlanta, Georgia, United States Sidecar Health Full timeAbout the RoleAs a Utilization Review Nurse at Sidecar Health, you will play a critical role in evaluating the medical necessity and quality of healthcare services for our members. This involves reviewing medical records, ensuring compliance with established clinical guidelines and policies, and collaborating with healthcare providers to gather additional...
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RN Medical Review Specialist
3 weeks ago
Atlanta, Georgia, United States Pyramid Consulting, Inc Full timeJob Opportunity: Medical Review Nurse - RNAbout the Role:We are seeking a talented Medical Review Nurse - RN to join our team at Pyramid Consulting, Inc. This is a 02+ Months Contract opportunity with long-term potential.Key Responsibilities:Conduct thorough medical reviews of patient records to ensure accuracy and qualityCollaborate with healthcare...
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Clinical Review Specialist
4 weeks ago
Atlanta, Georgia, United States Sonder Health Plans Full timeJob Description:The Clinical Review Specialist role at Sonder Health Plans is to ensure that healthcare services are administered with quality, cost efficiency, and within compliance.By continuously reviewing and auditing member treatment records, the Clinical Review Specialist will ensure members do not receive unnecessary procedures, ineffective treatment,...
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Underwriter I
5 days ago
Atlanta, Georgia, United States INSURICA Full timeJob SummaryWe are seeking a highly skilled Underwriter I to join our team at INSURICA. As an Underwriter I, you will be responsible for managing account activities and following sound practices to support company goals and objectives.Key ResponsibilitiesUnderwrite risks for assigned producers and/or teams, within established guidelines and personal authority...
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F&I Manager
2 weeks ago
Atlanta, Georgia, United States Hennessy Auto Group Full timeF&I Manager Job DescriptionAt Hennessy Auto Group, we're seeking a highly skilled F&I Manager to join our team. As a key member of our sales and finance department, you'll play a crucial role in providing exceptional customer experiences and driving business growth.Key Responsibilities:Present Vehicle Financing and Insurance Programs: Develop and present...