- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes ... regarding adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes clinical skills and knowledge of all applicable State and Federal… more
- Molina Healthcare (Tacoma, WA)
- …(occasional 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...supporting documentation for denial and modification of payments decisions. Remote position Work hours: Monday - Friday Monday 8:00am… more
- R1 RCM (Salt Lake City, UT)
- …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Nurse ** , you will help our ... basic computer skills is essential for excelling in this remote , production-driven position. **Here's what you will experience working...position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you will help ... basic computer skills is essential for excelling in this remote production-drive position. **Here's what you will experience working...position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** +… more
- R1 RCM (Detroit, MI)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Supervisor** , you will help support clinicians ... basic computer skills is essential for excelling in this remote position. **Here's what you will experience working as...position. **Here's what you will experience working as a Clinical Appeals Supervisor:** + Track and monitor… more
- Centene Corporation (Sacramento, CA)
- …of all appeals requests + Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry ... to work M-F 8-5 PST Hours. **Position Purpose:** Performs clinical reviews needed to resolve and process appeals...management processes preferred. **License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required or + LVN -… more
- VNS Health (Manhattan, NY)
- …Will Do + Responsible for direct oversight and the day to day management of clinical appeals review processes within Appeals & Grievances Department. + ... Health Plans is seeking a dedicated Manager, Grievance and Appeals (RN)to lead the daily operations of our grievance...and committee decisions. * Work Flexibly: Enjoy a mostly remote work environment with just one day a month… more
- Molina Healthcare (Everett, WA)
- …supporting our Appeals and Grievances department. We are seeking a Registered Nurse with previous claims and appeals experience. The candidate must have ... resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical … more
- Community Health Systems (Sarasota, FL)
- (Full-Time, Remote ) The Clinical Review Analyst is a professionally licensed nurse /LPN who is responsible for effectively managing the denial/appeal process ... without jeopardizing timely filing + Demonstrates excellent technical and clinical skills by drafting credible, defensible appeals ...accounts by following HIPAA guidelines + **This is a remote position.** We know it's not just about finding… more
- State of Colorado (Denver, CO)
- Charge Nurse RN II - CO Mental Health Hospital in Fort Logan (S. Denver) *$14,000 Sign On Bonus* Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4908308) Apply Charge Nurse RN II - CO Mental Health Hospital in Fort Logan (S. Denver) *$14,000… more