- Community Health Systems (Franklin, TN)
- **Job Summary** The Appeals Specialist II , under the direction of the Director of Denial Support Services, logs and reviews per documentation guidelines for ... regarding denials that are resulting in retractions. As an Appeals Specialist II at Community...spreadsheet software and database software. **Licenses and Certifications** + RN -BC - Certified General Nursing Practice current license to… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Appeals Specialist II , under the direction of the Director of Denial Support Services, logs and reviews per documentation guidelines for ... software, spreadsheet software and database software. **Licenses and Certifications** + RN -BC - Certified General Nursing Practice current license to practice in… more
- Stanford Health Care (Palo Alto, CA)
- …as excellent analytical and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, ... **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist II plays a critical role in...Cert Clinical Document Spec required within 180 Days + RN - Registered Nurse -… more
- Commonwealth Care Alliance (Boston, MA)
- …Claims Operations & Quality Assurance, the Regulatory Compliance & Audits Sr. Specialist II is responsible for ensuring CCA's operational compliance with ... * Translate regulatory updates into operational actions, collaborating with Claims, Appeals , UM, and Provider Services. * Conduct internal audits and retrospective… more
- The County of Los Angeles (Los Angeles, CA)
- …when needed to carry out job-related essential functions. A license to practice as a Registered Nurse issued by the California Board of Registered Nursing** ... -OR- a certificate or pocket license as a Registered Environmental Health Specialist issued by the...Certificate Section of the application is completed for the Registered Nurse License. Provide the title of… more
- Tufts Medicine (Melrose, MA)
- …the delivery of support services or activities, typically under supervision. A specialist level role that requires very advanced knowledge of operational procedures ... case management software. This position requires frequent communication with providers (MD, RPh, RN , NP, PA) on changes in adherence as well as any financial burden… more