- St. Luke's University Health Network (Allentown, PA)
- …communities we serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… more
- Highmark Health (Harrisburg, PA)
- …of clinical appeal activities to include but not limited to, clinical record review , composing comprehensive appeal letters and compiling minimum necessary ... 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
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …as necessary collaboration/supervision agreements with Advance Practice Professionals (Certified Registered Nurse Practitioners or Physician Assistants) and ... and Statistical Manual of Mental Disorders, written treatment orders, admissions on-call review for all legal commitment status documents and review and… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …as necessary collaboration/supervision agreements with Advance Practice Professionals (Certified Registered Nurse Practitioners or Physician Assistants) and ... history and physical examination, either written or dictated. This includes a review of the immunization status, allergies, past history, family history and… more