- R1 RCM (Detroit, MI)
- …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you ... this remote production-drive position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical… more
- R1 RCM (Salt Lake City, UT)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Supervisor** , you will ... guidelines. **Here's what you will experience working as a Clinical Coding Appeals Supervisor:** +...on a routine basis. **Required Skills:** + Active Registered Nurse license + Active AHIMA or AAPC Coding… more
- HCA Healthcare (Brentwood, TN)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Appeals Nurse RN you want with your current employer? We have an exciting ... of colleagues. Do you want to work as a Clinical Appeals Nurse RN where...root cause of each denial and apply company specific coding for trending and analysis. + Update the patient… 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...pharmacy, etc.). + Experience demonstrating knowledge of ICD-9, CPT coding and HCPC. + Experience demonstrating knowledge of CMS… more
- Molina Healthcare (Covington, KY)
- …for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making...pharmacy, etc.). + Experience demonstrating knowledge of ICD-9, CPT coding and HCPC. + Experience demonstrating knowledge of CMS… more
- Catholic Health (Buffalo, NY)
- …care team on an ongoing basis in relation to trends in denials, and clinical documentation. Responsible for working alongside coding , clinical documentation ... potential Summary: This position is accountable for carrying out and documenting the appeals process for denied claims denied due to reasons including, but not… more
- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal and ... Using knowledge of clinical nursing and medical practices, the Clinical Appeals Specialist will review medical necessity requests, render determinations… more
- Intermountain Health (Des Moines, IA)
- **Job Description:** The Manager, RN Revenue Integrity Audit, Recovery and Appeals organizes and manages the daily operations of the Audit and Recovery teams in the ... recoupment efforts. Additionally, the Manager will support coordinating efforts on clinical denials for medical necessity when needed and collaborate with external… more
- Centene Corporation (Austin, TX)
- … coding / clinical decisions on first time claims, adjustments and appeals in accordance with correct coding guidelines and Centene payment policies. ... by performing medical claim reviews to ensure compliance with coding guidelines through a comprehensive review and analysis of...a managed care organization preferred LPN - Licensed Practical Nurse - State Licensure required or RN - Registered… 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