7 claims nurse jobs at 5 companies in Hackensack, NJ
4d
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Medical Policy Analyst (Part-Time - 32 hrs weekly)
Newark, New Jersey, United States
$71k-$94k/yr RemotePart Time
3+ YOEHigh school diploma/GED and at least 3 years of clinical nursing experience. Requires communication, time management, judgment, problem-solving, prioritization, and production-focused work skills.
medical records, claims
2mo
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Senior Case Manager
New York, New York, United States
$100k-$130k/yr RemoteFull Time
5+ YOEActive unrestricted RN license required, 5+ years clinical nursing experience with case/care/ utilization management or discharge planning, ability to interpret claims/prior auth/ADT data and work independently.
MCG, InterQual, Admission/Discharge/Transfer (ADT)
4w
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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
4w
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Appeals and Grievances Clinical Specialist/ Quality Of Care
New York City or Lake Mary
$83k-$120k/yr HybridFull Time
Active RN required; experience in clinical practice and appeals & grievances, claims processing, utilization review or case management; knowledge of utilization review guidelines and ability to manage large caseloads.
Microsoft Word, Microsoft Excel, Macess, CCMS, TruCare, Hyland, InterQual, Milliman
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
5d
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RN Quality Practice Advisor (Newark, NJ)
Newark, New Jersey, United States
$89k-$135k/yr FieldFull Time
3+ YOEBachelor's degree, unrestricted RN license, BLS, 3+ years in healthcare or managed care, claims or gap closure experience preferred, driver's license, insurance, same-state residency, and frequent travel required.
Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
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