• 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 (04/07/25)
    - Save Job - Related Jobs - Block Source
  • Appeals and Grievances Clinical

    Healthfirst (PA)
    …OR Dental Hygienist Preferred Qualifications: + Bachelors degree + Experience in clinical practice with experience in appeals & grievances, claims processing, ... more
    Healthfirst (04/25/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse Clinical

    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
    Catholic Health (04/23/25)
    - Save Job - Related Jobs - Block Source
  • Clinical DRG Denials Specialist

    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
    Rochester Regional Health (04/26/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Appeals Nurse

    Molina Healthcare (Columbus, OH)
    …weekend per business need) Unrestricted RN licensure **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... more
    Molina Healthcare (04/27/25)
    - Save Job - Related Jobs - Block Source
  • 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 (04/10/25)
    - Save Job - Related Jobs - Block Source
  • 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 (04/24/25)
    - Save Job - Related Jobs - Block Source
  • 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)
    - Save Job - Related Jobs - Block Source
  • Specialist -Denial II RN

    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 (04/12/25)
    - Save Job - Related Jobs - Block Source
  • Specialist -Denial II RN

    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 (04/11/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Specialist RN

    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
    Fairview Health Services (04/22/25)
    - Save Job - Related Jobs - Block Source
  • RN Clinical Documentation Second…

    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
    University of Washington (04/10/25)
    - Save Job - Related Jobs - Block Source
  • 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)
    - Save Job - Related Jobs - Block Source
  • Pediatrics Clinical Nurse

    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 (04/20/25)
    - Save Job - Related Jobs - Block Source
  • 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)
    - Save Job - Related Jobs - Block Source
  • Clinical Documentation Specialist

    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
    Corewell Health (04/23/25)
    - Save Job - Related Jobs - Block Source
  • Inpatient Clinical & Coding…

    Independent Health (Buffalo, NY)
    …(RHIA), Registered Health Information Technician (RHIT), Certified Clinical Documentation Specialist (CCDS), American Health Information Management ... more
    Independent Health (04/15/25)
    - Save Job - Related Jobs - Block Source
  • 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 (04/23/25)
    - Save Job - Related Jobs - Block Source
  • Senior Compliance Oversight Specialist

    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
    Centene Corporation (04/25/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Documentation Specialist

    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
    CaroMont Health (04/17/25)
    - Save Job - Related Jobs - Block Source