- Elevance Health (Atlanta, GA)
- ** Nurse Appeals - Licensed RN Nurse ** **Location:** This position will work in a hybrid model (remote and office). Ideal candidates will live in Virginia, ... 5:00 pm ET (will work weekends and holidays as needed). The ** Nurse Appeals ** position is responsible for investigating and processing medical necessity … more
- CVS Health (Atlanta, GA)
- …coverage. Position Summary Responsible for the review and resolution of clinical appeals . Reviews documentation and interprets data obtained from clinical records to ... as required. This position may support UM, MPO, Coding, or Behavioral Health appeals . Required Qualifications + Must have active and unrestricted RN licensure in… more
- PruittHealth (Norcross, GA)
- …knowledge and ability to manage the Medicare and Medicaid denials and appeals process. + 6. Demonstrates ability to perform and document audits, including ... with other partners. **LICENSURE, CERTIFICATION AND EDUCATION REQUIREMENTS:** + Must be a Registered Nurse in good standing in at least one of the states in which… more