- Highmark Health (Harrisburg, PA)
- …Health Network **Job Description :** **GENERAL OVERVIEW:** Responsible for all aspects of clinical appeal activities to include but not limited to, clinical ... departments/Teams in denial prevention activities. **ESSENTIAL RESPONSIBILITIES** + Reviews clinical denials, audits and accounts as assigned.Composes and submits a… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals . The Appeals ... independent determination of the appropriate courses of action. The Appeals Nurse 2 reviews documentation and interprets...unrestricted RN license + 3 years of clinical RN Experience + Appeals … 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 ... and contractual requirements. + Documents, monitors, intervenes/resolves and reports clinical denials/ appeals and retrospective payer audit denials.… more