- 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
- Adecco US, Inc. (Minneapolis, MN)
- Adecco Healthcare & Life Sciences is hiring remote RN Appeals Reviewers! This role is remote / work from home. Please read below and apply with an updated resume ... **Pay:** $40.50 to $42.50 an hour **Responsibilities of the RN Appeals Reviewer:** . Responsible for conducting...and Holiday pay upon meeting eligibility criteria. **IMPORTANT:** This ** Registered Nurse ** role is being recruited for… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as an Inpatient Authorization Review Services Registered Nurse or Licensed Practical Nurse -NICU ... difference. We are looking for a dedicated Inpatient Authorization Review Services Registered Nurse or...care contracting, experienced preferred. + Currently licensed as a registered nurse ( RN ) in the… more
- Molina Healthcare (NE)
- …**Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with ... Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals ...RN license is required. **Job Duties** + Facilitates clinical/ medical reviews of retrospective medical claim reviews,… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… 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
- LA Care Health Plan (Los Angeles, CA)
- …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category:...clinical unit. This position is responsible for the quality review of complex and/or escalated clinical A&G cases for… more
- State of Colorado (Brighton, CO)
- Registered Nurse I, RN I - Prairie Vista Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5171479) Apply ... Registered Nurse I, RN I...practice. Obtains laboratory and other diagnostic procedures ordered by medical providers, review results and notify provider… more
- State of Colorado (Grand Junction, CO)
- Registered Nurse I, RN I - Grand Mesa Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5157862) Apply ... Registered Nurse I, RN I...practice. Obtains laboratory and other diagnostic procedures ordered by medical providers, review results and notify provider… more
- Elevance Health (Mason, OH)
- …on regulatory cases, including ensuring accurate entry, investigation, and analysis of state appeals ; summarizing medical information for review by ... ** Nurse Appeals -Licensed Nurse **...executive leadership by managing State Fair Hearing and External Medical Review requests. .Acts as a resource… more