• Clinical Appeals Specialist

    CDPHP (Albany, NY)
    …share these values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal ... more
    CDPHP (03/20/25)
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  • Clinical Appeals Specialist

    St. Luke's Health System (Twin Falls, ID)
    …a great place to work. **What You Can Expect:** Under limited supervision, the Clinical Appeals Specialist 2, is responsible for managing client medical ... more
    St. Luke's Health System (01/08/25)
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  • Grievance & Appeals Specialist

    VNS Health (Manhattan, NY)
    OverviewResolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage ... more
    VNS Health (02/07/25)
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  • Appeals and Grievances Clinical

    Healthfirst (AL)
    …degree + Case management/care management -QOC experience preferred + Experience in clinical practice with experience in appeals & grievances, claims processing, ... more
    Healthfirst (02/22/25)
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  • Prior Authorization and Appeals

    AscellaHealth (Berwyn, PA)
    What we are looking for Optime Care seeks a Prior Authorization and Appeals Specialist for our Berwyn, PA location. We are looking for someone who is passionate ... more
    AscellaHealth (03/13/25)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... more
    LA Care Health Plan (03/04/25)
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  • Medical Appeals & Coding Specialist

    University of Utah (Salt Lake City, UT)
    …Number** PRN41434B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals & Coding Specialist III **Job Grade** E **FLSA Code** ... more
    University of Utah (03/14/25)
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  • Remote Medical Appeals Specialist

    Community Health Systems (Fort Smith, AR)
    **Job Summary** The Appeals Specialist I is responsible for reviewing patient accounts denied for insurance reimbursement or paid incorrectly and following ... more
    Community Health Systems (03/22/25)
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  • Appeals and Grievance Specialist

    Baylor Scott & White Health (Temple, TX)
    **JOB SUMMARY** Hybrid position - Temple, TX The Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider ... more
    Baylor Scott & White Health (01/28/25)
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  • Clinical Appeals Nurse (RN): Texas…

    Molina Healthcare (Omaha, NE)
    …every 4 weeks Monday-Thursday and Wed - Saturday._** **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct ... more
    Molina Healthcare (02/09/25)
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  • Clinical Documentation and Denial…

    CaroMont Health (Gastonia, NC)
    …and DRG Denial Management and Appeals based on departmental needs. The Clinical Documentation and Denial Specialist is responsible for assisting the denial ... more
    CaroMont Health (02/21/25)
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  • OCYF Lead-Supervisor Clinical Review…

    State of Colorado (Denver, CO)
    OCYF Lead-Supervisor Clinical Review Specialist Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4858125) Apply  OCYF Lead-Supervisor ... more
    State of Colorado (03/15/25)
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  • OCYF Clinical Review Specialist

    State of Colorado (Denver, CO)
    OCYF Clinical Review Specialist Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4855247) Apply  OCYF Clinical Review Specialist ... more
    State of Colorado (03/15/25)
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  • Clinical & Coding Specialist

    Independent Health (Buffalo, NY)
    …coding guidelines and financial policies/contracts. + Responsible for all reconsideration clinical appeals to include review of records, consultation with ... more
    Independent Health (01/14/25)
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  • Medical Policy Clinical Specialist

    Premera Blue Cross (Mountlake Terrace, WA)
    …through our Healthsource blog: https://healthsource.premera.com/ . The **Medical Policy (MP) Clinical Specialist ** is a critical role in Premera, responsible ... more
    Premera Blue Cross (03/04/25)
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  • RN Clinical Coding Specialist

    Billings Clinic (Billings, MT)
    …Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! RN Clinical Coding Specialist FINANCE (Billings ... more
    Billings Clinic (01/28/25)
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  • Clinical Denials Coding Review…

    HCA Healthcare (Nashville, TN)
    …HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Denials Coding Review Specialist with Work from Home you can ... more
    HCA Healthcare (02/20/25)
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  • Clinical Integration Specialist

    Trinity Health (Des Moines, IA)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** The purpose of the Clinical Integration Specialist is to assist and support the Director in ... more
    Trinity Health (01/22/25)
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  • Clinical Nurse Specialist (Critical…

    City and County of San Francisco (San Francisco, CA)
    …and assists with designing and implementing plans for meeting such needs. The Clinical Nurse Specialist (Critical Care) performs other related duties as ... more
    City and County of San Francisco (02/22/25)
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  • Appeal Specialist RN

    Rush University Medical Center (Chicago, IL)
    …by the Care Management Department and Rush University Medical Center. 9. Coordinates clinical appeals process and participates in in compliance investigations as ... more
    Rush University Medical Center (03/15/25)
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