- Molina Healthcare (Everett, WA)
- **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within ... compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical reviews of previously denied cases in which… more
- Mindful Support Services (Seattle, WA)
- …both personally and professionally. About the role: The Insurance Follow-Up Specialist is responsible for reviewing rejected claims, posting insurance payments, and ... calls and portal navigation + Claims reprocessing requests, corrected claims, and appeals + Navigating many commercial insurances such as Blue Cross/Blue Shield,… more
- Evolent (Olympia, WA)
- …guidance and expertise to ensure the application of best practices. + Provides clinical rationale for standard and expedited appeals . + Discusses determinations ... Are you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular… more