- Elevance Health (Costa Mesa, CA)
- ** Nurse Appeals ( RN )** **Location** : This role requires associates to be in-office **1-2** days per week, fostering collaboration and connectivity, while ... may be considered. **Shift: Monday to Friday from 8:00am-5:00pm PST** The ** Nurse Appeals ** is responsible for investigating and processing medical necessity… more
- Elevance Health (Tampa, FL)
- ** Nurse Appeals ** **Location** : **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... skill development. **Expected Work Hours: Monday-Friday OR Tuesday-Saturday; 8am-5pm** The ** Nurse Appeals ** is responsible for investigating and processing… 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 ... colleagues. Do you want to work as a Clinical Appeals Nurse RN where your...qualifications you will need:** + Currently licensed as a Registered Nurse ( RN ) in the… more
- R1 RCM (Salt Lake City, UT)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Appeals Nurse ** , you will help our hospital clients by ... **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct a detailed review...at telephonic hearings if needed. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
- Molina Healthcare (Tacoma, WA)
- … appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of ... these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- R1 RCM (Chicago, IL)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical ... what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical...external compliance deadlines are met. **Required Skills:** + Active Registered Nurse license + An active CCS,… more
- Evolent (Providence, RI)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
- Actalent (Rancho Cordova, CA)
- Job Title: Registered NurseJob Description The Commercial Appeals and Grievance Registered Nurse ( RN ) reviews and processes appeals resulting ... other nationally recognized sources such as NCCN and ACOG. The RN reviews appeals for benefits, medical necessity, coding accuracy, and medical policy… more
- State of Colorado (Golden, CO)
- Registered Nurse I, RN I...of the department's action. For more information about the appeals process, the official appeal form, and how to deliver ... Mountain, Youth Services Center - Golden Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4935383) Apply Registered Nurse I, RN I -… more
- Select Medical (Los Angeles, CA)
- …Cedars, UCLA and Select Medical Century City / Los Angeles, CA Case Manager (CM) - Registered Nurse ( RN ) or Social Worker (LCSW) **Per Diem** **Pay Rate: ... valid state licensure in Social Work required or Current state licensure as a Registered Nurse required. + Previous experience in Case Management and Discharge… more