5 claims nurse jobs at 3 companies in Carson, CA
3w
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Medical Review Nurse (RN) - UM/Appeals experience
Florida or Long Beach
OnsiteFull Time
2+ YOEActive unrestricted RN license, 2+ years clinical nursing with ≥1 year utilization review or claims review, knowledge of ICD-10/CPT/HCPC, regulatory requirements, and strong analytic and communication skills.
ICD-10, CPT, HCPC, MCG/InterQual, Microsoft Office
3w
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Utilization Review Nurse LVN
Ontario, California, United States
$72k-$100k/yr OnsiteFull Time
2+ YOEActive CA LVN license, 2+ years acute hospital case management, utilization management experience, knowledge of claims, coding and billing, high school diploma/GED, strong interpersonal skills.
1w
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Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)
Denver or Atlanta or Costa Mesa or Hanover or Walnut Creek or Chicago or Las Vegas or Mendota Heights or New York City or Seattle
$87k-$156k/yr RemoteFull Time
10+ YOEActive unrestricted RN license; 10 years in claims auditing, quality assurance, or clinical documentation improvement; 5 years with ICD-9/10-CM and DRG systems. Preferred coding or documentation credentials.
ICD-9, ICD-10-CM, MS-DRG, AP-DRG, APR-DRG
2w
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Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)
Mason or Atlanta or Costa Mesa or Hanover or Indianapolis or Las Vegas or Denver or New York or Chicago or Norfolk
$87k-$156k/yr RemoteFull Time
10+ YOEActive unrestricted RN license, 10+ years claims auditing/quality or CDI experience, 5+ years DRG coding experience (ICD-9/10CM, MS-DRG/AP-DRG/APR-DRG), audit expertise and clinical documentation knowledge.
ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG
3w
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Remote Clinical Validation Reviewer (RN)
Long Beach, California, United States
$26-$57/hr RemoteFull Time
2+ YOEActive unrestricted RN license, 2+ years inpatient payment integrity claim review including DRG validation, expertise with ICD-10/MS-DRG/AP-DRG/APR-DRG/CPT/HCPCS, clinical decision tools, and Microsoft Office.
ICD-10, MS-DRG, AP-DRG, APR-DRG, CPT, HCPCS, UpToDate, Merck Manual, Microsoft Office