- Molina Healthcare (Grand Rapids, MI)
- …for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you will help ... remote production-drive position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to… more
- R1 RCM (Detroit, MI)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Supervisor** , you will help support clinicians ... position. **Here's what you will experience working as a Clinical Appeals Supervisor:** + Track and monitor...additional support and engagement. **Required Skills:** + Active Registered Nurse license For this US-based position, the base pay… more
- Corewell Health (Farmington Hills, MI)
- …criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization ... management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan License Upon Hire required How Corewell… more
- Molina Healthcare (Ann Arbor, MI)
- …state, and local laws and regulatory requirements affecting the medical and clinical staff. **Job Duties** + Provides medical oversight and expertise in ... medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the investigation of adverse… more