- Molina Healthcare (Rochester, NY)
- 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
- Garnet Health (Middletown, NY)
- …Garnet Health Medical Center. Responsibilities Under the direction of The Administrator, Coding & Clinical Documentation Improvement and Patient Access, the ... knowledge, required* Exceptional ability to communicate effectively with physicians and other clinical professional staff.* Knowledge of DRG and Coding appeal… more
- Catholic Health (Buffalo, NY)
- …for training and mentoring Utilization Review, Clinical Documentation Integrity and Clinical Denials and Appeals teams. They ensure the teams receive ... coverage as needed Summary: The Middle Revenue Cycle - Clinical Supervisor, as an active member of the Middle...+ Bachelor of Science Nursing (BSN) degree + Registered Nurse with a current New York State license CERTIFICATION… more
- Molina Healthcare (Albany, NY)
- …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