- Molina Healthcare (Kearney, NE)
- JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals ... regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Assesses appropriateness of services, length of stay and… more
- Omaha Children's Hospital (Omaha, NE)
- …and obtains appropriate physician documentation while patients are in-house for clinical conditions and procedures to support the appropriate severity of illness, ... and complexity of care of the patient. Exhibits sufficient knowledge of clinical documentation requirements. APR-DRG assignment and clinical conditions and… more
- Molina Healthcare (Bellevue, NE)
- …for a RN with experience with appeals , claims review, and medical coding . JOB DESCRIPTION Job SummaryProvides support for clinical member services review ... For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is...that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members… more
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