• Clinical Appeals Specialist

    HCA Healthcare (Nashville, TN)
    …TN, TX, UT, VA). Do you want to join an organization that invests in you as a Clinical Appeals Specialist Medicare RN or LPN? At Parallon, you come ... and you have the opportunity to make a difference. We are looking for a dedicated Clinical Appeals Specialist Medicare RN or LPN like you to be a part… more
    HCA Healthcare (10/24/25)
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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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  • UR Registered Nurse - Clinical

    Cognizant (Washington, DC)
    …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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  • Utilization Rev Appeals Spec

    University of Michigan (Ann Arbor, MI)
    …Medicine's Hospital Billing Audits & Appeals (HBAA) Department?** The Audit and Appeals Specialist has a strong knowledge of medical appeal and audit ... They are knowledgeable about insurance requirements and medical billing practices. The Appeals Specialist will collaborate with multiple departments to maintain… more
    University of Michigan (10/25/25)
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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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  • 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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  • 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 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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  • Prior Authorization Specialist

    US Tech Solutions (RI)
    …volume where needed. **Responsibilities:** + Utilizing multiple software systems to complete Medicare appeals case reviews + Meeting or exceeding government ... **Job Title: Prior Authorization Specialist ** **Location: Fully remote** **Duration: 12 months contract**...internal groups regarding determination status and results (seniors, pharmacists, appeals , etc). + Identify and elevate clinical more
    US Tech Solutions (08/08/25)
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