• RN Clinical Review Appeals

    St. Luke's University Health Network (Allentown, PA)
    …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… more
    St. Luke's University Health Network (07/08/25)
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  • Registered Nurse ( RN

    LifePoint Health (Hickory, NC)
    * Registered Nurse ( RN ), Clinical Case...the lives of those we serve.** *Connect with our RN recruiting specialist * Not ready to complete ... prohibiting discrimination and harassment in employment." **Job:** **Nursing* **Organization:** ** **Title:** * Registered Nurse ( RN ), Clinical Case… more
    LifePoint Health (07/16/25)
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  • Clinical Appeals Nurse

    Molina Healthcare (GA)
    … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must...with internet connectivity of high speed required **Job Summary** Clinical Appeals is responsible for making appropriate… more
    Molina Healthcare (08/02/25)
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  • Registered Nurse or Physical…

    CenterWell (Honolulu, HI)
    …or requested. **Use your skills to make an impact** **Required Experience/Skills:** + Registered Nurse or Physical Therapist. + Current state license as a ... and help us put health first** The **Denials Management Specialist ** is responsible to respond to, monitor and analyze... Registered Nurse or Physical Therapist. + 5… more
    CenterWell (07/30/25)
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  • CDOC Registered Nurse ( Nurse

    State of Colorado (CO)
    CDOC Registered Nurse ( Nurse I) Print...RN license. 07 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4963973) Apply  CDOC Registered Nurse ( Nurse I) Salary $7,591.00 - $10,627.00 Monthly… more
    State of Colorado (06/06/25)
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  • CDOC Registered Nurse - Part-time

    State of Colorado (Sterling, CO)
    CDOC Registered Nurse - Part-time - Sterling Print...Yes + No 06 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4992041) Apply  CDOC Registered Nurse - Part-time - Sterling Salary...Colorado? If so, what state issued your license? 07 Nurse Licensure Compact: If appointed to an RN more
    State of Colorado (07/01/25)
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  • Appeals and Grievance Specialist

    Commonwealth Care Alliance (Boston, MA)
    011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances ... well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with regulations. Additionally, this position is responsible… more
    Commonwealth Care Alliance (05/21/25)
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  • RN Clinical Integration…

    Trinity Health (Des Moines, IA)
    …(https://www.mercyone.org/desmoines/find-a-location/)** Join the MercyOne Family! We are looking to hire a RN Clinical Integration Specialist . The purpose of ... the Clinical Integration Specialist is to assist and support the Director in...Day Shift **General Requirements:** + Iowa licensure as a Registered Nurse . + Member of a professional… more
    Trinity Health (06/11/25)
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  • Specialist -Denial II RN

    Baptist Memorial (Memphis, TN)
    …in a payer hearing or clinical meeting when indicated. The Denial Mitigation-Appeal Specialist II RN may have the opportunity to work remotely after 90 days ... Overview Specialist -Denial Mitigation II RN Job Code:...determine next steps. In accordance with the guidelines, the Specialist compiles an appeal along with pertinent clinical more
    Baptist Memorial (07/11/25)
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  • Denials Management Specialist ( RN

    St. Luke's University Health Network (Allentown, PA)
    …of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and tracks ... preparing reports regarding denials to include volumes, number of appeals , case resolution, and impact on revenue and trending....an accredited, professional nursing program. + Must have current RN license to practice in the state of Pennsylvania… more
    St. Luke's University Health Network (05/14/25)
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