• Clinical Appeals Specialist

    HCA Healthcare (Nashville, TN)
    …TX, UT, VA). Do you want to join an organization that invests in you as a Clinical Appeals Specialist Medicare ? At Parallon, you come first. HCA ... and you have the opportunity to make a difference. We are looking for a dedicated Clinical Appeals Specialist Medicare like you to be a part of our team.… more
    HCA Healthcare (10/19/25)
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  • Clinical Appeals Specialist

    Dana-Farber Cancer Institute (Brookline, MA)
    Under the general supervision of the Director of Patient Financial Services, the Clinical Appeals Specialist performs advanced level work related to ... comprehensive review of relevant clinical documentation. The Clinical Appeals Specialist will write...trends; including denials that have been escalated to the Medicare Administrative Law Judge (ALJ). + Represent DFCI at… more
    Dana-Farber Cancer Institute (09/05/25)
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  • Registered Nurse - Clinical Appeals

    Cognizant (Atlanta, GA)
    …cycle or clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and concurrent reviews . ... the Health Plan/Medical Director based on the review of clinical documentation in accordance with Medicare , Medicaid,...stand out** . Epic experience . Experience in drafting appeals disputing inpatient clinical validations audits is… more
    Cognizant (10/09/25)
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  • Appeals Quality and Training…

    Martin's Point Health Care (Portland, ME)
    …has been certified as a "Great Place to Work" since 2015. Position Summary The Appeals Quality and Training Specialist supports the Appeals Department. This ... line of business within Martin's Point Health Care, including Medicare Advantage, US Family Health Plan (USFHP). + Demonstrates...projects. + Independently partners with Medical Directors and other clinical support staff on appeals requiring … more
    Martin's Point Health Care (10/07/25)
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  • Medicare Billing Specialist

    Insight Global (Pleasanton, CA)
    Job Description Insight Global is seeking a Medicare Billing Specialist to join their clients team. The Medicare Billing Specialist is responsible for ... the accurate preparation, submission, and reconciliation of Medicare claims for outpatient mental health services. This role ensures compliance with Medicare more
    Insight Global (10/03/25)
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  • Denials Prevention & Appeals Coordinator-…

    Nuvance Health (Danbury, CT)
    …Hours 5-9pm- Rotate Weekends/Evenings* *Summary:* Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, ... in liaising with all above parties to submit provider appeals to insurance companies including Medicare and...facilitates communications with the System Business Office related to appeals , denial and clinical reviews 9. Reviews… more
    Nuvance Health (10/10/25)
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  • Clinical Government Audit Analyst & Appeal…

    Stanford Health Care (Palo Alto, CA)
    …analytical and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, coding ... is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist ...Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and… more
    Stanford Health Care (10/10/25)
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  • Clinical Pharmacy Specialist - Prior…

    UPMC (Pittsburgh, PA)
    UPMC Health Plan is hiring a full-time Clinical Pharmacy Specialist to support the Prior Authorization Team within the Pharmacy Services department. This is a ... for licensure by examination or reciprocity is required. The Clinical Pharmacy Specialist provides clinical ...in managing member care through the prior authorization and appeals process for medications. These services will be provided… more
    UPMC (10/15/25)
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  • Clinical Denials Coding Review…

    HCA Healthcare (Brentwood, TN)
    …HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Denials Coding Review Specialist with Parallon you can be a ... you need to succeed in our organization. We are looking for an enthusiastic Clinical Denials Coding Review Specialist to help us reach our goals. Unlock… more
    HCA Healthcare (09/05/25)
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  • Revenue Cycle Specialist - Plastics…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect revenue cycle support to the Revenue Cycle Managers. It is ... identified by the Revenue Cycle Managers. In addition, the Revenue Cycle Specialist is responsible for resolving all outstanding third-party primary and secondary… more
    Houston Methodist (10/08/25)
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