- 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
- University of Washington (Seattle, WA)
- …**UW Medicine's Patient Financial Services Department** has an outstanding opportunity for a ** Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + ... FTE + 100% Remote + Days **POSITION HIGHLIGHTS** The Clinical Appeals and Disputes Nurse ...and communicated payer decisions in a timely manner + Review clinical denials and initiate appeals… more
- Centene Corporation (Little Rock, AR)
- …that all appeal letters generated comply with both State and NCQA requirements. + Review clinical information for all appeals utilizing nationally recognized ... analyze and report verbal and written information regarding member and provider clinical appeals , including information follow up + Prepare response letters… 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 (Lansing, MI)
- …utilizing templates in Word, and typing on the computer. + Responsible for the review and resolution of clinical appeals . + Reviews documentation and ... day. **Position Summary** CVS Aetna is seeking a dedicated ** Appeals Nurse Consultant** to join our remote...3+ years clinical experience. **Preferred Qualifications** + Appeals , Managed Care, or Utilization Review experience.… more
- State of Colorado (Brighton, CO)
- Registered Nurse I, RN I - Prairie Vista Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5171479) Apply ... Registered Nurse I, RN I...including physical, psychiatric and dental maintenance. Specific Job Duties: Clinical Duties: Initial nursing assessments and triage of requests… more
- State of Colorado (Grand Junction, CO)
- Registered Nurse I, RN I - Grand Mesa Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5177091) Apply ... Registered Nurse I, RN I...including physical, psychiatric and dental maintenance. Specific Job Duties: Clinical Duties: Initial nursing assessments and triage of requests… more
- LA Care Health Plan (Los Angeles, CA)
- …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC ... unit. This position is responsible for the quality review of complex and/or escalated clinical A&G… more
- Cognizant (Salem, OR)
- …to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. + Review clinical denials including but not limited… more
- Nuvance Health (Danbury, CT)
- *Description* *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within the first 12-24 hours ... critical part in preventing payment denials by providing timely and accurate clinical information to all payers, while ensuring compliance with CMS requirements,… more