• Clinical Appeals and Disputes Nurse

    University of Washington (Seattle, WA)
    …Medicine's Patient Financial Services Department** has an outstanding opportunity for a **Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + 100% FTE + ... 100% Remote + Days **POSITION HIGHLIGHTS** The Clinical Appeals and Disputes Nurse ensures that payers are prepared to reimburse the UW Medicine for services in… more
    University of Washington (12/19/25)
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  • Appeals Nurse

    Evolent (Olympia, WA)
    …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 utilization management by adhering to Evolent and… more
    Evolent (12/24/25)
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  • Clinical Registered Nurse - Utilization…

    Cognizant (Olympia, WA)
    …to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical ... + Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes.… more
    Cognizant (12/23/25)
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  • RN / Registered Nurse - Endocrine Clinic

    University of Washington (Seattle, WA)
    …- Endocrine Care Center** has an outstanding opportunity for a **Registered Nurse .** **WORK SCHEDULE** + 40 hours per week + Monday-Friday, 8:30am-5:00pm + ... their caregivers + Manage prescriptions and assist with insurance appeals for specialty medications + Handle the care coordination...experience + Active licensure to practice as a Registered Nurse in Washington State + Active BLS + IV… more
    University of Washington (11/26/25)
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  • Family Health Advocate - Remote

    Sharecare (Olympia, WA)
    …enrollment / new hire plan selection, claims issues, ID card issues, grievances/ appeals , utilization management (UM) status, including but not limited to medical, ... 3rd parties for: + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status +...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
    Sharecare (12/13/25)
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  • Medical Director (NV)

    Molina Healthcare (Spokane, WA)
    …medical necessity. * Participates in and maintains the integrity of the appeals process, both internally and externally. * Responsible for investigation of adverse ... and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends… more
    Molina Healthcare (11/21/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Tacoma, WA)
    For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of high ... set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. JOB DESCRIPTION Job...equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
    Molina Healthcare (12/24/25)
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