- R1 RCM (Detroit, MI)
- …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you ... this remote production-drive position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical… more
- R1 RCM (Salt Lake City, UT)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Supervisor** , you will ... guidelines. **Here's what you will experience working as a Clinical Coding Appeals Supervisor:** +...on a routine basis. **Required Skills:** + Active Registered Nurse license + Active AHIMA or AAPC Coding… more
- HCA Healthcare (San Antonio, TX)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Appeals Nurse you want with your current employer? We have an exciting ... of colleagues. Do you want to work as a Clinical Appeals Nurse where your...root cause of each denial and apply company specific coding for trending and analysis. + Update the patient… more
- Molina Healthcare (Albany, NY)
- …for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... every 4 weeks Monday-Thursday and Wed - Saturday._** **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct … more
- Catholic Health (Buffalo, NY)
- …care team on an ongoing basis in relation to trends in denials, and clinical documentation. Responsible for working alongside coding , clinical documentation ... potential Summary: This position is accountable for carrying out and documenting the appeals process for denied claims denied due to reasons including, but not… more
- CVS Health (Hartford, CT)
- …and every day. Position Summary Responsible for the review and resolution of clinical appeals . Reviews documentation and interprets data obtained from ... support as required. This position may support UM, MPO, Coding , or Behavioral Health appeals . Required Qualifications...(RN) licensure in state of residence * 3+ years clinical experience Preferred Qualifications * Appeals Experience… more
- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal and ... Using knowledge of clinical nursing and medical practices, the Clinical Appeals Specialist will review medical necessity requests, render determinations… more
- Intermountain Health (Des Moines, IA)
- **Job Description:** The Manager, RN Revenue Integrity Audit, Recovery and Appeals organizes and manages the daily operations of the Audit and Recovery teams in the ... recoupment efforts. Additionally, the Manager will support coordinating efforts on clinical denials for medical necessity when needed and collaborate with external… more
- Molina Healthcare (WI)
- …supporting our Appeals and Grievances department. We are seeking a Registered Nurse with previous claims and appeals experience. The candidate must have ... resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical … more
- CVS Health (Charleston, WV)
- … coverage, and policies. Responsible for the review and resolution of clinical complaints/grievances and appeals . Interprets data obtained from clinical ... RN, MD, etc.). Commands a comprehensive knowledge of complex delegation arrangements, coding logic, contracts (member and provider), clinical criteria, benefit… more