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 The RN will work 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. Required knowledge includes accreditation standards (i.e., URAC, NCQA) and health insurance legislation. Awareness of claims processes and claims processing systems is essential. PC proficiency is required, including Microsoft Word, Excel, and health insurance databases. Strong verbal and written communication skills are necessary to effectively communicate with physicians, members, and providers, as well as to compose and explain document findings. Organizational and prioritization skills are also important. Minimum Requirements: Registered Nurse (RN) with unrestricted license in state. 3 years clinical experience. Ability to navigate MCG and medical policies during reviews. #J-18808-Ljbffr HireOps Staffing, LLC
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We are looking for skilled Heavy Equipment Technicians. This person must have at least three years of experience performing complex, in-depth repairs to construction equipment.aa415a4b-8b21-40fc-a65c-70d2b25ca29a
...We are hire for a Fiber Optic Technician! This role is responsible for installing, maintaining, testing, and troubleshooting fiber optic cable systems, which are critical for high-speed internet, telephone, and data transmission services. Supervisory Responsibilities...
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...Job Description Job Description BAYADA Staffing has immediate needs for registered nurses / RNs to work as a substitute school nurse in Chester County schools. Per-diem and/or long-term assignments available Flexible scheduling! As an accredited, regulated...