- R1 RCM (Detroit, MI)
- …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you ... more
- R1 RCM (Chicago, IL)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Supervisor** , you will ... more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …is eligible for the eWorker persona.The TeamAs an integral part of the Clinical Appeals team, the Appeals Nurse Reviewer will serve as a liaison and ... more
- Molina Healthcare (Omaha, NE)
- …for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... more
- McLaren Health Care (Port Huron, MI)
- …outcomes and fulfills the obligation and responsibilities of the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer ... more
- 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
- City and County of San Francisco (San Francisco, CA)
- … documentation reflects the appropriate level of service. + Utilizes both clinical and coding knowledge effectively. + Performs initial inpatient chart ... more
- CaroMont Health (Gastonia, NC)
- …pre-existing criteria sets and/or clinical evidence from existing library of clinical coding references and/or regulatory arguments. Search for supporting ... more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- …defense, LifeNet and special focus audits and reports findings. + Serves as a clinical resource for coding / denial management and customer service issues. + ... more
- Molina Healthcare (Columbus, GA)
- …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... more
- US Tech Solutions (Columbia, SC)
- …and appeals . Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. ... more
- 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
- Premera Blue Cross (Mountlake Terrace, WA)
- …information into summary statements for inclusion in policy documents. + Liaise with Clinical Appeals Department to regularly review data from same specialty and ... more
- US Tech Solutions (Columbia, SC)
- …and appeals . Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. ... more
- Nuvance Health (Danbury, CT)
- …and operational oversight for a team of utilization review staff, denials and appeals specialists, non- clinical support staff while partnering with local case ... more
- Trinity Health (Troy, NY)
- …_CHRI_ certification/membership _strongly_ preferred + Must possess a demonstrated knowledge of clinical processes, clinical coding (CPT, HCPCS, ICD-9/10, ... more
- Apex Health Solutions (Houston, TX)
- …carrying out day today pre-authorization functions. The Utilization Review Nurse will also be responsible for issuing pre-authorization approvals/denials, notifying ... more
- RWJBarnabas Health (New Brunswick, NJ)
- …Documents in appropriate billing systems + Coordinates with the physician or nurse as needed to obtain clinical information. Retrieves information from ... more
- Sutter Health (Berkeley, CA)
- …start and continuity of services. Works in conjunction with managed care and coding departments to maintain accuracy in clinical and billing information. **Job ... more
- UNC Health Care (Chapel Hill, NC)
- …with Medical Surgical and/or Psychiatry bedside experience. The team: + Completes clinical reviews for all areas: Inpatient, Observation, Extended Recovery + Ensures ... more