- 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
- Community Health Systems (Franklin, TN)
- **Job Summary** The Appeals Specialist II, under the direction of the Director of Denial Support Services, logs and reviews per documentation guidelines for ... more
- Healthfirst (AL)
- …degree + Case management/care management -QOC experience preferred + Experience in clinical practice with experience in appeals & grievances, claims processing, ... more
- 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 ... more
- Molina Healthcare (Columbus, OH)
- … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... 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 ... more
- City and County of San Francisco (San Francisco, CA)
- …of experience working as a Registered Nurse SPECIALTY REQUIREMENTS: + Clinical Documentation Specialist (CCDS) certification + At least 3 years of ... 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 ... more
- University of Michigan (Ann Arbor, MI)
- …Medicine's Hospital Billing Audits & Appeals (HBAA) Department?** The Audit and Appeals Specialist has a strong knowledge of medical appeal and audit ... more
- Billings Clinic (Billings, MT)
- …to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! RN Clinical Coding Specialist ... more
- Rush University Medical Center (Chicago, IL)
- …with Rush policies and procedures. **Other information:** **Required Job Qualifications:** * Licensed, registered nurse in the State of IL with at least 5 ... more
- AdventHealth (Altamonte Springs, FL)
- …utilizing InterQual and/or MCG . Minimum of three (3) years' experience as Registered Nurse ( RN ) in an acute clinical setting . Clinical experience ... more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and tracks ... more
- City and County of San Francisco (San Francisco, CA)
- …( RN ) license issued by the California Board of Registered Nursing; AND + Clinical Nurse Specialist Certificate: Possession of a valid Clinical ... more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Technology). (Required) + Registered Nurse , Physician's Assistant, or Nurse Practitioner with five (5) years' clinical experience. (Required) + Four ... more
- 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
- Independent Health (Buffalo, NY)
- …(RHIA), Registered Health Information Technician (RHIT), Certified Clinical Documentation Specialist (CCDS), American Health Information Management ... more
- PeaceHealth (Vancouver, WA)
- …clinical DRG-downgrade denials in the inpatient acute care setting Credentials + Required: Registered Nurse In state of practice or + Required: Certified ... more
- Trinity Health (Des Moines, IA)
- …health administration or related field required. + Iowa licensure as a Registered Nurse . + Member of a professional healthcare organization.Demonstrated ... more
- State of Colorado (CO)
- …Rights MINIMUM QUALIFICATIONS: + Applicant must possess a current, valid license as a Registered Nurse from the Colorado Board of Nursing or any state ... more
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