- St. Luke's University Health Network (Allentown, PA)
- …ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… more
- Centene Corporation (New York, NY)
- …State Licensure required or + LVN - Licensed Vocational Nurse required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure ... Purpose:** Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical...analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with… more
- R1 RCM (Salt Lake City, UT)
- …orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical records to draft appeals of denied and underpaid ... experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical...external compliance deadlines are met. **Required Skills:** + Active Registered Nurse license + Active AHIMA or… more
- R1 RCM (Salt Lake City, UT)
- …conduct a comprehensive review of clinical denials and formulate appeals based on clinical documentation, evidence-based medical necessity criteria, ... identify targeted areas for additional support and engagement. **Required Skills:** + Active Registered Nurse license For this US-based position, the base pay… more
- Nuvance Health (Danbury, CT)
- …in nursing, health administration, or a related field preferred * Current licensure as a registered nurse ( RN ) * Minimum of 5 years of clinical experience ... leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical...medical necessity outreach, and feedback to the utilization review team on denial outcomes. * *Discharge Planning &… more
- State of Colorado (Denver, CO)
- …(HP III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5049341) Apply Registered Nurse Health Compliance Inspector Home Care - ... Registered Nurse Health Compliance Inspector Home Care -...FAA00094 (HP III RN ) Salary $80,916.00 Annually Location Denver, CO Job Type Full Time… more
- State of Colorado (Denver, CO)
- …(HP III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5058918) Apply Registered Nurse Complaints Health Compliance Inspector - ... Registered Nurse Complaints Health Compliance Inspector -...FAA00731 (HP III RN ) Salary $80,916.00 - $90,648.00 Annually Location Denver, CO Job… more
- Mount Sinai Health System (Long Island City, NY)
- …field. **Licensing and Certification Requirements (if applicable)** Licensed as a registered nurse , Issuing Agency: Department of Health/Office of Professions ... The Director will direct and manage departmental activities involved in utilization review , appeals management and discharge planning to facilitate the case… more
- Ascension Health (Pensacola, FL)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Florida Board of Nursing ... obtained prior to hire dateor job transfer date required. Licensed as a Registered Nurse in Florida required. Credentialed from State Board ofNursing or current… more
- State of Colorado (Denver, CO)
- …III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5058892) Apply Registered Nurse Health Compliance Inspector, Nursing ... Registered Nurse Health Compliance Inspector, Nursing...Facilities - FAA00392 (HP III RN ) Salary $80,916.00 Annually Location Denver, CO Job Type… more
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