- Henry Ford Health System (Troy, MI)
- …Alliance Plan (HAP) is looking to grow our Medical Appeals Team with an experienced Registered Nurse ! We are a team of Registered Nurses (3 and counting) ... and Utilization Review Coordinators (4) that review appeals for medical necessity using established...Microsoft Word. Excel and Access preferred. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse ( RN ) with current… more
- Cognizant (Lansing, MI)
- …expectations. **What you need to have to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines… more
- McLaren Health Care (Port Huron, MI)
- …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm **Hours Per Pay...participates in the resolution of retrospective reimbursement issues including appeals , PACER authorization, third party payer certification, and denied… more
- Evolent (Lansing, MI)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of...work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators… more
- Molina Healthcare (Warren, MI)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... Looking for a RN with experience with appeals , claims review , and medical coding. JOB...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (MI)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... Description** **Job Summary** Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal… more
- Corewell Health (Royal Oak, MI)
- …in care management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon Hire ... Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2. Responsible for managing… more