• 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

    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
    Community Health Systems (03/26/25)
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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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  • 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 ... more
    LA Care Health Plan (03/04/25)
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  • Clinical Appeals Nurse

    Molina Healthcare (Columbus, OH)
    … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... more
    Molina Healthcare (02/09/25)
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  • CDOC Registered Nurse ( Nurse

    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
    State of Colorado (03/17/25)
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  • Registered Nurse [ Clinical

    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
    City and County of San Francisco (02/04/25)
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  • CDOC Registered Nurse - Part-time

    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
    State of Colorado (03/18/25)
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  • Utilization Rev Appeals Spec

    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
    University of Michigan (03/25/25)
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  • RN Clinical Coding Specialist

    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
    Billings Clinic (01/28/25)
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  • Appeal Specialist RN

    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
    Rush University Medical Center (03/15/25)
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  • Denials Management RN Specialist

    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
    AdventHealth (01/27/25)
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  • Denials Management Specialist ( RN

    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
    St. Luke's University Health Network (02/12/25)
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  • Clinical Nurse Specialist

    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
    City and County of San Francisco (02/22/25)
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  • Medical Policy Clinical Specialist

    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
    Premera Blue Cross (03/04/25)
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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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  • Clinical & Coding Specialist

    Independent Health (Buffalo, NY)
    …(RHIA), Registered Health Information Technician (RHIT), Certified Clinical Documentation Specialist (CCDS), American Health Information Management ... more
    Independent Health (01/14/25)
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  • RN -Denial Reviewer - remote

    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
    PeaceHealth (03/12/25)
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  • Clinical Integration Specialist

    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
    Trinity Health (01/22/25)
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  • CDOC Nurse Supervisor

    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
    State of Colorado (03/18/25)
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