- HCA Healthcare (Brentwood, TN)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Appeals Nurse RN you want with your current employer? We have an exciting ... caring group of colleagues. Do you want to work as a Clinical Appeals Nurse RN where your passion for creating positive patient interactions is valued? If… more
- R1 RCM (Salt Lake City, UT)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Appeals Nurse ** , you will help our hospital clients by ... production-driven position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct a detailed review of patient medical records and… more
- Molina Healthcare (Tacoma, WA)
- …appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct...denied cases in which a formal appeals request has been made or upon request by… more
- R1 RCM (Chicago, IL)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical ... position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to appeal denied and underpaid… more
- CVS Health (Salem, OR)
- …8a-5p in time zone of residence **Monday - Friday.** **Position Summary** The Appeals Nurse Consultant position is responsible for processing the medical ... necessity of Medicare appeals for participating providers. Primary duties may include, but...+ Managed Care experience + Utilization Management experience + Appeals experience + Pre Certification experience + Pre Authorization… more
- Evolent (Cheyenne, WY)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Evolent Appeals Nurse 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… more
- Elevance Health (Costa Mesa, CA)
- ** Nurse Appeals Lead (RN)** **Location** : This role requires associates to be in-office **1-2 days per week** , fostering collaboration and connectivity, while ... locations may be considered. **Shift:** Monday to Friday from 8:00am-5:00pm **PST** The ** Nurse Appeals Lead** is responsible for serving as a team lead and for… more
- Evolent (Providence, RI)
- …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
- TEKsystems (San Bernardino, CA)
- Description We are seeking a dedicated Clinical Appeals Nurse to join our Revenue Cycle Management team. The ideal candidate will be responsible for managing ... involves reviewing medical records, preparing clinical documentation to support appeals , and following up on submitted appeals ....support appeals , and following up on submitted appeals . The Clinical Appeals Specialist will work… more
- Actalent (Rancho Cordova, CA)
- Job Title: Registered NurseJob Description The Commercial Appeals and Grievance Registered Nurse (RN) reviews and processes appeals resulting from ... reviewing all medical records and documentation concurrently while processing these appeals . The role involves performing accurate and timely first-level reviews… more