1368 Rn jobs in Moore,SC

Medical Review Nurse -UM/Post Appeals (Michigan RN license req)

Molina Healthcare

Spartanburg, SC 29302

At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical review), medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and unrestricted in state of practice.
Compact license is acceptable where states allow.
Experience demonstrating knowledge of ICD-10, Current Procedural Technology (CPT) coding and
Healthcare Common Procedure Coding (HCPC).
Experience working within applicable state, federal, and third-party regulations.
Analytic, problem-solving, and decision-making skills.
Organizational and time-management skills.
Attention to detail.
Critical-thinking and active listening skills.
Common look proficiency.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software program(s) proficiency.

Hobby Lobby

Moore, SC

U.S. Navy

Woodruff, SC 29388

ENCOMPASS HEALTH

Mauldin, SC 29662

CoreMedical Group Perm

Laurens, SC 29360

CenterWell Home Health

Greenville, SC 29607

Prisma Health

Greenville, SC 29610

Spartanburg Regional Healthcare System

Spartanburg, SC 29301

Materials Sciences LLC

Greenville, SC 29615

High School diploma
Must have basic math and mechanical knowledge, manual dexterity, good eyesight and the ability to perform repetitive tasks
United States Citizen
Understanding of basic tools
Willingness to learn and embrace MSC processes