• Clinical Appeals Nurse

    BayCare Health System (Clearwater, FL)
    …working remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Clinical Appeals Nurse - Health Plan **Location** Clearwater:Park ... years of experience with case management and/or clinical appeals or claims. + Registered Nurse **Facility:** BayCare Health System, Admin - Non Hospital… more
    BayCare Health System (12/19/25)
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  • Registered Nurse (RN) Manager,…

    LA Care Health Plan (Los Angeles, CA)
    Registered Nurse (RN) Manager, Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & Grievances ... Clinical ) is responsible for the daily oversight of clinical appeals and grievances functions within the...experience with at least 3 years of experience with health care grievance and/or appeals issues, preferably… more
    LA Care Health Plan (12/09/25)
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  • Clinical Appeals and Disputes…

    University of Washington (Seattle, WA)
    …**UW Medicine's Patient Financial Services Department** has an outstanding opportunity for a ** Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + ... FTE + 100% Remote + Days **POSITION HIGHLIGHTS** The Clinical Appeals and Disputes Nurse ...YOUR IMPACT GOES FURTHER** UW Medicine is Washington's only health system that includes a top-rated medical school and… more
    University of Washington (12/19/25)
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  • Grievance & Appeals Nurse (RN)

    Elevance Health (Mason, OH)
    ** Nurse Appeals -Licensed Nurse **...Medical Review requests. .Acts as a resource for both clinical and non- clinical teams, by managing and ... necessary and is dependent on court hearing schedules. The Nurse Appeals is responsible for investigating and....Current active unrestricted RN license to practice as a health professional within the scope of licensure in applicable… more
    Elevance Health (12/12/25)
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  • Nurse Appeals RN-Ohio

    Elevance Health (Columbus, OH)
    ** Nurse Appeals RN** **Location** : Ohio-Cincinnati, Columbus, Mason, or Seven Fields _(Must be within commutable distance to the listed locations.)_ ... an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and.../grievances/quality of care issues and is a resource for clinical and non clinical team members in… more
    Elevance Health (12/17/25)
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  • Appeals Nurse Consultant - Must Live…

    CVS Health (Baton Rouge, LA)
    …recommend solutions. In particular responsible for the review and resolution of clinical documentation, clinical complaints and appeals . Reviews ... At CVS Health , we're building a world of health...in Louisiana Responsible for intake, investigation and resolution of appeals , complaints and grievances scenarios for all products, which… more
    CVS Health (12/17/25)
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  • Appeals Nurse Consultant - Work…

    CVS Health (Hartford, CT)
    At CVS Health , we're building a world of health...in time zone of residence Monday - Friday. The Appeals Nurse Consultant position is responsible for ... ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health ...processing the medical necessity of Medicare appeals for participating providers. Primary duties may include, but… more
    CVS Health (12/20/25)
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  • Clinical Appeals Specialist

    BJC HealthCare (St. Louis, MO)
    …work experience) **Additional Information About the Role** BJC HealthCare is seeking a Clinical Appeals Specialist to assist with infusion appeals for ... government and commercial plans. This individual will be handling clinical denials and sending them to a nurse...clinical denials for BJC hospitals and payors. The Clinical Appeals Specialist must be able to… more
    BJC HealthCare (12/19/25)
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  • Clinical Appeals LVN

    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 ... support appeals , and following up on submitted appeals . The Clinical Appeals Specialist...employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee… more
    TEKsystems (12/11/25)
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  • RN Clinical Review Appeals

    St. Luke's University Health Network (Allentown, PA)
    …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and ... as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless… more
    St. Luke's University Health Network (10/28/25)
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