- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes ... regarding adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes ...**Education Level:** High School Diploma or GED. **Licenses/Certifications:** + RN - Registered Nurse -… 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 ... of colleagues. Do you want to work as a Clinical Appeals Nurse RN...qualifications you will need:** + Currently licensed as a Registered Nurse ( RN ) in the… more
- Molina Healthcare (Tacoma, WA)
- …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...these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Molina Healthcare (Covington, KY)
- … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making...these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- R1 RCM (Salt Lake City, UT)
- …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Nurse ** , you will help our ... position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct...at telephonic hearings if needed. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you will help ... position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** +...external compliance deadlines are met. **Required Skills:** + Active Registered Nurse license + An active CCS,… more
- Catholic Health (Buffalo, NY)
- …as related to DRG and level of care denial trends. Responsibilities: EDUCATION + Registered Nurse with a current New York State license + Bachelor of ... 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
- 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 ... recoupment efforts. Additionally, the Manager will support coordinating efforts on clinical denials for medical necessity when needed and collaborate with external… more
- State of Colorado (CO)
- CDOC Registered Nurse ( Nurse I) Print...RN license. 07 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4762850) Apply CDOC Registered Nurse ( Nurse I) Salary $7,442.00 Monthly Location Statewide,… more
- State of Colorado (Sterling, CO)
- CDOC Registered Nurse - Part-time - Sterling Print...Yes + No 06 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4756062) Apply CDOC Registered Nurse - Part-time - Sterling Salary...Colorado? If so, what state issued your license? 07 Nurse Licensure Compact: If appointed to an RN… more