• Clinical Appeals Nurse

    Molina Healthcare (TX)
    …weekend per business need) Unrestricted RN licensure **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making...these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (04/27/25)
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  • Clinical Appeals Nurse

    Molina Healthcare (Austin, TX)
    … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making...these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
    Molina Healthcare (04/10/25)
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  • Registered Nurse Manager Revenue…

    Intermountain Health (Austin, TX)
    **Job Description:** The Manager, RN Revenue Integrity Audit, Recovery and Appeals organizes and manages the daily operations of the Audit and Recovery teams in ... recoupment efforts. Additionally, the Manager will support coordinating efforts on clinical denials for medical necessity when needed and collaborate with external… more
    Intermountain Health (04/26/25)
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  • Hospice Director of Clinical Operations

    HCA Healthcare (Arlington, TX)
    …Works with subject matter experts (eg Operations, Education, Centers for Clinical Advancement, Survey Readiness, Regulations, Compliance, Appeals team) to ... hours impacting our communities. As a Hospice Director of Clinical Operations with HCA Hospice and Family Care, you...software and virtual meeting platform experience required. + Valid RN license within practice state required. + Certified Hospice… more
    HCA Healthcare (03/30/25)
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  • Manager - Case Management and Social Work

    Houston Methodist (Houston, TX)
    …performance that demonstrates progressive leadership abilities **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure ... and/or Compact State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -...**AND** + Magnet - ANCC Recognized Certification -- If RN within 1 year + LCSW- License Clinical more
    Houston Methodist (04/29/25)
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  • Senior Medical Coding Reviewer

    Centene Corporation (Austin, TX)
    …organization preferred LPN - Licensed Practical Nurse - State Licensure required or RN - Registered Nurse - State Licensure and/or Compact State ... & objectives of Corporate and health plans. + Provide coding/ clinical decisions on first time claims, adjustments and ...clinical decisions on first time claims, adjustments and appeals in accordance with correct coding guidelines and Centene… more
    Centene Corporation (04/24/25)
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