- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is seeking a highly motivated and results-driven **UM RN Appeals Coordinator.** This role collaborates with clinical review staff, ... evenings and weekends, to address pharmacy-related denials + Educates physician reviewers and clinical review staff on managed care and Medicaid policies and… more
- Stanford Health Care (Palo Alto, CA)
- …Days or + CCDS - Cert Clinical Document Spec required within 180 Days + RN - Registered Nurse - State Licensure And/Or Compact State Licensure preferred ... Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and...likelihood of a successful appeal. + Proofreading and Editing: Review and edit appeals for clarity and… more
- St. Luke's University Health Network (Allentown, PA)
- …communities we serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… more
- McLaren Health Care (Grand Blanc, MI)
- …of the patient care team. Educates health team colleagues about complex clinical appeals /denials, utilization review , including role, responsibilities tools, ... and methodologies. _Required:_ + State licensure as a Registered Nurse ( RN ) + Bachelor's...utilization review experience + Five years of clinical nurse experience in an acute care… more
- Centene Corporation (Salem, OR)
- …that all appeal letters generated comply with both State and NCQA requirements. + Review clinical information for all appeals utilizing nationally recognized ... RN or LPN** **Oregon state license **Utilization review , case management, and appeals experience in...report verbal and written information regarding member and provider clinical appeals , including information follow up +… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- CVS Health (Hartford, CT)
- …it all with heart, each and every day. **Position Summary** Responsible for the review and resolution of clinical appeals . Reviews documentation and ... unrestricted RN licensure in state of residence * 3+ years clinical experience **Preferred Qualifications** * Appeals Experience * Managed Care Experience… more
- State of Colorado (Denver, CO)
- …(HP III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5155064) Apply Registered Nurse Health Compliance Inspector Home Care - ... health, safety, and well-being of Colorado communities. As a Registered Nurse ( RN ) Health Professional...through direct observation, staff and consumer interviews, and record review . + Applying professional judgment and clinical … more
- Molina Healthcare (Salt Lake City, UT)
- **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal appeals clinical processes - ensuring that ... health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
- State of Colorado (Denver, CO)
- …III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5120373) Apply Registered Nurse Health Compliance Inspector, Nursing ... Registered Nurse Health Compliance Inspector, Nursing...Facilities - FAA00221 (HP III RN ) Salary $80,916.00 Annually Location Denver, CO Job Type… more
Recent Jobs
-
Senior Paralegal - Defense Litigation
- Fluor (Irving, TX)
-
Skills Building Internships!
- The Arc Erie County NY (Williamsville, NY)