Total searched jobs are :2

• UM NURSE - PRIOR AUTHORIZATION

  The Utilization Management (UM) Nurse is responsible for medical necessity review of incoming referrals, Pre-Service, Retro and Post Claims requests. The UM Nurse will review the submitted request and supporting clinical records for Medical Necessity ...Read More

  Posted: 02-20-2021

• CLAIMS AUDITOR - HOAG CLINIC CLAIMS & ENROLLMEN

  Job Summary: The Claims Auditor is responsible for performing pre-payment and post-payment audits ensuring financial and processing accuracy, compliance with regulatory and health plan requirements of claims processed. The Claims Auditor is resp ...Read More

  Posted: 02-03-2021