Claims Nurse Reviewer - Hingham, MA, United States - BlueCross & BlueShield of Massachusetts

claims nurse reviewer

2 weeks ago

Ready to help us transform healthcare? Bring your true colors to blue. · The Role · The Claims Nurse Reviewer is responsible for reviewing claims, validating coding and medical necessity of the services submitted and pricing the claims according to appropriate guidelines. This po ...

Claims Nurse Reviewer

3 weeks ago

The Role · The Claims Nurse Reviewer is responsible for reviewing claims, validating coding and medical necessity of the services submitted and pricing the claims according to appropriate guidelines. This position requires strong clinical and medical coding skills to review claim ...

Utilization Management Nurse Reviewer

3 days ago

**Why This Role is Important to Us**: · The Nurse Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CC ...

Nurse Reviewer, Endoscopy

2 weeks ago

Under the direction of the Nurse Director of the BWPO's South Shore Endoscopy Center (SSEC), the Registered Nurse GI Case Reviewer will work as a critical member of the procedural care team to support the quality, efficiency and satisfaction of care taking place at the SSEC. The ...

utilization review nurse

2 weeks ago

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. · Job Type: · Regular · Scheduled Hours: · 8 · Work Shift: · Day (United States of America) · Lahey Hospital and Medical Center is now offering up to a $3,500 in signi ...

utilization review nurse

2 weeks ago

Job Type: Regular · Time Type: Full time · Work Shift: Evening (United States of America) · FLSA Status: Non-Exempt · When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. · Job Type: · Regular · Scheduled Hours: · 40 · W ...

utilization review nurse

3 weeks ago

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. · Job Type: · Regular · Scheduled Hours: · 40 · Work Shift: · Evening (United States of America) · Lahey Hospital and Medical Center is now offering up to a $3,500 in ...

Utilization Review Nurse

1 week ago

Job Type: Regular · Time Type: Full time · Work Shift: Night (United States of America) · FLSA Status: Non-Exempt · When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. · Job Type: · Regular · Scheduled Hours: · 40 · Wor ...

Unit Coordinator

3 weeks ago

**Job Description Summary** · The Unit Coordinator/Secretary through communication, requisitioning and management of supplies and equipment, coordinates the activities of the nursing staff, the patient, the physician, other Hospital departments and visitors. He/she performs gener ...

Utilization Review Nurse Manaer

2 weeks ago

Arrow Mutual Liability Insurance is seeking a talented individual for the position of UR Nurse Manager/UR nurse to determine the quality of care provided to injured workers including whether the medical services/procedures are appropriate and effective, performing Prospective, Co ...

Acute Registered Nurse

2 weeks ago

POSITION FEATURES: · This position will sit in Brockton Hospital · Dialysis experience required · PURPOSE AND SCOPE: · The Inpatient RN provides direct patient care in accordance to company policies and procedures which includes FMCNA compliance programs and contracted hospitals ...

Acute Inpatient Dialysis Registered Nurse

18 hours ago

POSITION FEATURES:This position will sit in Brockton Hospital · Dialysis experience required · $7,500 Sign On Bonus Included · PURPOSE AND SCOPE: · The Inpatient RN provides direct patient care in accordance to company policies and procedures which includes FMCNA compliance prog ...

Perinatal Outpatient Diabetes Program Coordinator

2 weeks ago

**Job Description Summary** · Responsible for the operation of the diabetes self-management education program, including supervisor of staff and program planning, development, implementation and evaluation. (Salary Range: $35.79-$69.09) · ESSENTIAL FUNCTIONS · 1. Provide overall ...

Imaging Resource Specialist Ii

1 week ago

**_**Hiring for our Weymouth location, 40 hours, Monday-Friday, 8:00am - 4:30pm.**_** · **Hiring rates are determined by experience, starting at $23.80/hr.** · Atrius Health, an innovative healthcare leader, delivers an effective system of connected care for more than 690,000 adu ...

Ccu Equipment and Resource Coordinator

2 days ago

**Job Description Summary** · Reporting into the Manager, Distribution & Logistics in Materials Management, with direction and guidance from the Critical Care Nurse Manager, the Critical Care Resource Coordinator is responsible for the coordination of services needed to support t ...

Director of Student Services

2 weeks ago

District Overview Cohasset is a small, coastal town located 20 miles south of Boston. Boasting two beaches, a state park, and several woodland preserves, Cohasset is a place where residents are out and about enjoying everything the town has to offer. It is a community in every se ...

Acute Dialysis Services Program Manager

2 weeks ago

PURPOSE AND SCOPE: · Ensure the provision of quality patient care to all hospitalized patients in the most efficient manner in accordance with company policy. Provides direct supervision and coordination of inpatient staff. Responsible for low volume monthly treatments. Utilizes ...

Medical Assistant

2 weeks ago

**When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.** · **Job Type**: · Regular · **Scheduled Hours**: · 40 · **Work Shift**: · Day (United States of America) · The Medical Assistant provides high quality, direct pati ...

Supervisor/ Geriatric Support Services

3 weeks ago

**JOB OPPORTUNITY** · South Shore Elder Services, Inc. a dynamic Human Services Agency has the following opportunity available for a caring, well-organized individual who enjoys working with elders. We offer excellent fringe benefits and a pleasant work environment (3 weeks vacat ...

Resident Care Director

2 weeks ago

**Resident Care Director** · Our community is seeking a compassionate and caring Resident Care Director. This role is responsible for hiring, training, and managing the care staff at our community. This role will also serve as the liaison with physicians, family members, and outs ...