- Evolent (Harrisburg, PA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
- Cognizant (Harrisburg, PA)
- …to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical ... . Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes.… more
- Highmark Health (Pittsburgh, PA)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care and manages ... contractual requirements. + Documents, monitors, intervenes/resolves and reports clinical denials/ appeals and retrospective payer audit denials. Collaboratively formulates plans… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …collaboration/supervision agreements with Advance Practice Professionals (Certified Registered Nurse Practitioners or Physician Assistants) and provide ongoing ... including but not limited to development of standards, insurance company appeals and teleconferences and provision of prior authorization information; +… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …collaboration/supervision agreements with Advance Practice Professionals (Certified Registered Nurse Practitioners or Physician Assistants) and provide ongoing ... including but not limited to development of standards, insurance company appeals and teleconferences and provision of prior authorization information; e.… more