North Carolina Licensed Medical Review Analyst

Company: VirtualVocations
Location: Vista
Posted on: May 20, 2025

Job Description:

A company is looking for a Medical Review Analyst to evaluate medical necessity and reimbursement for complex claims.
Key Responsibilities

Determine medical necessity, benefit eligibility, and reimbursement allowances for complex claims using clinical expertise and various resources
Ensure compliance with regulatory and accrediting body requirements during reviews and determinations
Document and report inappropriate billing patterns and conduct post adjudication reviews of claims

Required Qualifications

RN, PA, or NP with a minimum of 3 years of clinical experience, preferably in diverse clinical settings
LPN with a minimum of 5 years of clinical nursing experience in varied clinical environments
Must hold and maintain a valid North Carolina clinical license

Keywords: VirtualVocations, Rowland Heights , North Carolina Licensed Medical Review Analyst, Professions , Vista, California

Click here to apply!

Didn't find what you're looking for? Search again!

Let Vista recruiters find you. Post your resume for free!

Get Vista Professions jobs via email.

View more Rowland Heights Professions jobs

Other Professions Jobs

Senior Medical Economics Analyst
Description: A company is looking for a Senior Medical Economics Analyst VBC . br Key Responsibilities br br Develop and maintain dashboards
Company: VirtualVocations
Location: Vista
Posted on: 05/19/2025

Test Technician (Electro-Mechanical)
Description: 804 Technology is currently looking for an Test Technician for a long term contract job opportunity located in Simi Valley CA that is immediately available. The Test Technician, completes work according (more...)
Company: 804 Technology
Location: Simi Valley
Posted on: 05/19/2025

Local Owner Operator Truck Driver in Los Angeles, CA
Description: br br Call us at 844-205-6340 br br Roadrunner's unique LTL business model is designed to let you be the boss. As a CDL A Local Owner Operator truck driver, you'll build relationships with our (more...)
Company: RoadRunner
Location: Torrance
Posted on: 05/19/2025

Salary in Rowland Heights, California Area | More details for Rowland Heights, California Jobs |Salary

Fleet Maintenance Fueler Washer
Description: 19646 Figueroa St Carson CA 90745 What's the Job Ready to accelerate your career while helping our customers move forward As a Fleet Maintenance Fueler Washer at Penske, you'll do exactly that. You (more...)
Company: Penske
Location: Carson
Posted on: 05/19/2025

SZ: 1st shift-Maintenance Technician
Description: Come create your career with Volt br br Do you have the following skills, experience and drive to succeed in this role Find out below. br br Volt is immediately hiring for a Maintenance Technician (more...)
Company: Volt
Location: South Gate
Posted on: 05/19/2025

Fleet Maintenance Fueler Washer
Description: br br 19646 Figueroa St Carson CA 90745 What's the Job Ready to accelerate your career while helping our customers move forward As a Fleet Maintenance Fueler Washer at Penske, you'll do exactly (more...)
Company: Penske
Location: Carson
Posted on: 05/19/2025

Non CDL Yard Jockey
Description: br br Local Non CDL Yard Jockey - 22.75 / Hour Looking for a local driving career with great compensation, a dependable schedule, and full employee benefits Forward is
Company: Forward
Location: Orange
Posted on: 05/19/2025

Plumbers - Service & Repair Technicians
Description: You're at the top of your game.--You know your trade, and have mastered it over time, but you need to keep challenging yourself, keep learning, and keep growing. You thrive on having a full schedule, (more...)
Company: Barker and Sons Plumbing
Location: Orange
Posted on: 05/19/2025

Supervisor, Distribution
Description: br br Preferred Qualifications ul li Bachelor's degree in a related field. li 5 plus years of experience working in a distribution center. li 2 plus years of experience in a lead or mentorship (more...)
Company: HD Supply
Location: Downey
Posted on: 05/19/2025

Shipping and Receiving Coordinator
Description: Job Designation br br Are you the right candidate for this opportunity Make sure to read the full description below. br The Shipping and Receiving Coordinator supports Shipping and Receiving Team (more...)
Company: 804 Technology
Location: Simi Valley
Posted on: 05/19/2025

Loading more jobs...

North Carolina Licensed Medical Review Analyst

Didn't find what you're looking for? Search again!

Other Professions Jobs

Log In or Create An Account