- 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, medical ... to ensure consistent clinical evaluation and processing of medical necessity appeals . Accurate documentation and detailed recordkeeping of notifications to members… more
- Alameda Health System (Oakland, CA)
- …background. Required Licenses/Certifications : Valid license to practice as a Registered Nurse in the State of California. Preferred Licenses/Certifications ... of quality improvement initiatives. Oversees the secondary review process; actively appeals denied cases when necessary and assists physicians with appeals… more
- Commonwealth Care Alliance (Boston, MA)
- …Referral and authorization; Regulatory compliance; Billing and payments; Complaints and appeals ; Policies and procedures. + Identify opportunities for training and ... record, (if applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer.… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations (Clinical) Job Category: Clinical Department: CSC Appeals & Grievances ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- State of Colorado (Grand Junction, 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 ... - Grand Mesa Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5157862) Apply Registered Nurse I, RN I - Grand… 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:...as assigned. Education Required Associate's Degree in Nursing for Registered Nurses Education Preferred Bachelor's Degree in Nursing for… more
- Adecco US, Inc. (Minneapolis, MN)
- Adecco Healthcare & Life Sciences is hiring remote RN Appeals Reviewers! This role is remote / work from home. Please read below and apply with an updated resume ... **Pay:** $40.50 to $42.50 an hour **Responsibilities of the RN Appeals Reviewer:** . Responsible for conducting...and Holiday pay upon meeting eligibility criteria. **IMPORTANT:** This ** Registered Nurse ** role is being recruited for… more
- Elevance Health (Mason, OH)
- **Manager II Grievance/ Appeals - RN ** **Location** : Ohio-Cincinnati, Columbus, Mason, or Seven Hills ( _Must be within commutable distance to one of the listed ... unless an accommodation is granted as required by law._ The **Manager II Grievance/ Appeals ** is responsible for management oversight of grievances and appeals … more
- University of Washington (Seattle, WA)
- …Medical Center-Montlake - Endocrine Care Center** has an outstanding opportunity for a ** Registered Nurse .** **WORK SCHEDULE** + 40 hours per week + ... - this position will be the only full time RN on the team **PRIMARY JOB RESPONSIBILITIES** + Provide...nursing experience + Active licensure to practice as a Registered Nurse in Washington State + Active… more
- St. Luke's University Health Network (Allentown, PA)
- …Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. . ... of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding… more
- Elevance Health (Mason, OH)
- ** Nurse Appeals -Licensed Nurse ** **Location** : Ohio, candidates must be residents of Ohio to be considered. **Hybrid 1** : This role requires associates to ... necessary and is dependent on court hearing schedules. The Nurse Appeals is responsible for investigating and...which would provide an equivalent background. .Current active unrestricted RN license to practice as a health professional within… more
- CommonSpirit Health (Centennial, CO)
- …BSN required Minimum Experience required: 4 years clinical experience as a Registered Nurse . 3 years with progressive experience in utilization review, ... help you flourish and leaders who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue management liaison for all care… more
- Elevance Health (Columbus, OH)
- ** Nurse Appeals RN ** **Location** : Ohio-Cincinnati, Columbus, Mason, or Seven Fields _(Must be within commutable distance to the listed locations.)_ ... an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and...would provide an equivalent background. + Current active unrestricted RN license to practice as a health professional within… more
- Elevance Health (Tampa, FL)
- ** Nurse Appeals ** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and...would provide an equivalent background. + Current active unrestricted RN license to practice as a health professional within… more
- Community Health Systems (Franklin, TN)
- …of insurance claims processing and denial management workflows. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... and supports initiatives that improve denial prevention and recovery processes. As an Appeals Specialist II at Community Health Systems (CHS) - SSC Nashville, you'll… 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/5123731) Apply CDOC Registered Nurse ( Nurse I) Salary $7,591.00 - $10,627.00 Monthly… more
- Sacramento County (Sacramento, CA)
- …read and understood the above instructions. 02 Select the one box that best describes your Registered Nurse ( RN ) license issued by the State of California. + ... Registered Nurse D/CF (Level I/II) Print...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- Sacramento County (Sacramento, CA)
- Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply Supervising Registered Nurse ... 5:00 pm on: 12/1/25, 2/2/26, 4/6/26, 6/1/26, 8/3/26, 10/5/26, 12/7/26 Supervising Registered Nurse - Detention/Correctional Facility is the first level… more
- State of Colorado (Pueblo, CO)
- Registered Nurse I - Nursing Residency Program - CMHHIP - Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5145740) Apply ... Registered Nurse I - Nursing Residency Program...updates on CDHS recruiting events! CDHSCareers Description of Job RN Residency Program Objective: This position will provide novice… more
- State of Colorado (Pueblo, CO)
- Nurse I - Registered Nurse ...if your application is eliminated. You will find the appeals process, the official appeal form, and how to deliver ... - CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5130579) Apply Nurse I - Registered Nurse I - CMHHIP Salary $43.80 - $61.31… more
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