- 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
- Healthfirst (PA)
- …OR Dental Hygienist Preferred Qualifications: + Bachelors degree + Experience in clinical practice with experience in appeals & grievances, claims processing, ... 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 ... more
- Rochester Regional Health (Rochester, NY)
- …denials from external payers and their contractors. The Clinical Denial Specialist writes and submits professionally written appeals which include compelling ... more
- Molina Healthcare (Columbus, OH)
- …weekend per business need) Unrestricted RN licensure **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... 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
- 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
- Baptist Memorial (Memphis, TN)
- …in a payer hearing or clinical meeting when indicated. The Denial Mitigation-Appeal Specialist II RN may have the opportunity to work remotely after 90 days ... more
- Baptist Memorial (Memphis, TN)
- …in a payer hearing or clinical meeting when indicated. The Denial Mitigation-Appeal Specialist II RN may have the opportunity to work remotely after 90 days ... more
- Fairview Health Services (St. Paul, MN)
- **Job Overview** **Join Our Team at Fairview as a Utilization Management Specialist RN - 100% Remote!** _Help shape patient care and outcomes, from the comfort ... more
- University of Washington (Seattle, WA)
- …- MONTLAKE** has an outstanding opportunity for a **Second Level Review Clinical Documentation Integrity Specialist ( RN ).** **WORK SCHEDULE** Full-time ... 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
- Corewell Health (Southfield, MI)
- …required in an acute inpatient hospital setting. 1 of 4 Certification required + LIC- Registered Nurse ( RN ) - STATE_MI State of Michigan. + LIC-Physician ... more
- Independent Health (Buffalo, NY)
- …(RHIA), Registered Health Information Technician (RHIT), Certified Clinical Documentation Specialist (CCDS), American Health Information Management ... 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
- Centene Corporation (Jefferson City, MO)
- …designed to evaluate internal and third party/subcontractor compliance with clinical aspects of government-sponsored health care program requirements, State Medicaid ... more
- CaroMont Health (Gastonia, NC)
- …for promoting and monitoring safe, high-quality, cost-effective healthcare with the best clinical outcomes possible. Provide physician and nurse education to ... more
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