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Appeals and Grievances Clinical Specialist
New York City or Lake Mary or New York or North Dakota or Indiana or Virginia or Texas or Tennessee or South Carolina or Pennsylvania or Ohio or Nevada or New Jersey or North Carolina or Minnesota or Maryland or Massachusetts or Kansas or Illinois or Iowa or Georgia or Florida or Delaware or Connecticut or Colorado or New Hampshire or Vermont or Arizona or Alabama or Maine or Utah or Mississippi or Montana or South Dakota or Nebraska or New Mexico or Washington or Michigan or Oklahoma
$73k-$120k/yr RemoteFull Time
Active registered nurse (rn) required; experience in appeals & grievances, utilization review, claims processing preferred; familiarity with Utilization Review guidelines and care management systems; strong documentation and case management skills.
Microsoft Word, Microsoft Excel, Macess, CCMS, TruCare, Hyland, InterQual, Milliman
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Supervisory Legal Administrative Specialist
Salt Lake City or Seattle or Phoenix or Los Angeles or San Francisco or Denver or Washington or Miami or Atlanta or Chicago or Indianapolis or New Orleans or Boston or Minneapolis or Kansas City or Albuquerque or New York or Oklahoma City or Portland or Austin or Camp Springs
$64k-$83k/yr HybridFull Time
1+ YOEU.S. citizen, secret clearance, pass background and drug screening; 1 year specialized experience (GS-09 equivalent) performing legal/administrative immigration case processing, research, and workflow evaluation.
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Orthopedic Surgery Workers Compensation Specialist
Boston, Massachusetts, United States
$25-$37/hr OnsiteFull Time
3+ YOEAssociates in business/legal required (Bachelors preferred). Minimum 3 years clerical/insurance experience and 1 year work comp adjuster/case manager experience preferred. Knowledge of workers' compensation laws, claims processing, scheduling, and strong communication and analytical skills.
Microsoft PowerPoint, Microsoft Word