- 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
- Adecco US, Inc. (Minneapolis, MN)
- …per week, eight-hour days **Pay:** $40.50 to $42.50 an hour **Responsibilities of the RN Appeals Reviewer :** . Responsible for conducting thorough reviews of ... high-quality work and meeting production goals. **Qualifications for the RN Appeals Reviewer :** . Associates...and Holiday pay upon meeting eligibility criteria. **IMPORTANT:** This ** Registered Nurse ** role is being recruited for… 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
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… 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...laboratory and other diagnostic procedures ordered by medical providers, review results and notify provider of results when indicated.… 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...laboratory and other diagnostic procedures ordered by medical providers, review results and notify provider of results when indicated.… more
- Elevance Health (Mason, OH)
- ** Nurse Appeals -Licensed Nurse ** **Location** : Ohio, candidates must be residents of Ohio to be considered. **Hybrid 1** : This role requires associates to ... necessary and is dependent on court hearing schedules. The Nurse Appeals is responsible for investigating and...including ensuring accurate entry, investigation, and analysis of state appeals ; summarizing medical information for review by… more
- CommonSpirit Health (Centennial, CO)
- …Education: BSN required Minimum Experience required: 4 years clinical experience as a Registered Nurse . 3 years with progressive experience in utilization ... resources to help you flourish and leaders who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue management liaison for… more
- Elevance Health (Tampa, FL)
- ** Nurse Appeals ** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and...medical information for medical director, consultants and other external review . + Prepares recommendations to either uphold or deny… more
- Nuvance Health (Danbury, CT)
- …REQUIRED* * *Hybrid/Remote* * *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within ... behaviors to internal leadership for assistance in resolution. *Responsibilities:* * Review all inpatient admission and observation cases using InterQual, or… more