- Molina Healthcare (Yonkers, NY)
- …for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they...with internet connectivity of high speed required **Job Summary** Clinical Appeals is responsible for making appropriate… more
- Molina Healthcare (Yonkers, NY)
- …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... Medical Surgical, or Pediatrics. Advanced Practice Nursing. Billing and coding experience. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical … more
- Elderwood (Liverpool, NY)
- Salary $38.00 - $49.50 / hourly Overview Are you a Registered Nurse (RN) with Medicare experience? Do you consider yourself an expert in assessment and reimbursement ... of Benefits Program + Increased Tuition Reimbursement Program for Clinical Tracks + Shift Differentials + Full Benefits Package...for pre and post-pay record reviews, ADR requests and appeals processes. + Manages NYS RUGs III case mix… more
- Stony Brook University (Stony Brook, NY)
- …a **Case Manager** is a valuable member of our team, who provides clinical services to our patient population. Qualified candidates will demonstrate superior patient ... the hospital stay. + Assist with coverage for UR, Appeals and denials + Actively involved in performance improvement...required. **Qualifications** **Required** : A Bachelor's degree or a nurse working on their degree with an RN license… more