- Evolent (Frankfort, KY)
- …Join a mission with a company behind it. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a meaningful impact ... and procedures while complying with timeliness guidelines. Our clinical nurse reviewer team values collaboration, continuous learning, and a...and Preferred** : + 1-3 years' experience in clinical Appeals Review and is an LPN -… more
- CVS Health (Frankfort, KY)
- …the state of Kentucky **Preferred Qualifications** Managed Care experience Prior Appeals experience **Education** LPN /LVN with current unrestricted state ... Responsible for the review and resolution of clinical complaints/grievances and appeals . Interprets data obtained from clinical records to apply appropriate clinical… more
- BrightSpring Health Services (Louisville, KY)
- …Overview Director of Clinical Denials Management and Audit supervises a team of RN/ LPN clinical reviewers as well as Support staff managing all areas of clinical ... claim pre and post audit, appeals submission, and reporting to Palmetto in response to...to minimize lost revenue. Conducts analysis on denials and appeals and identifies trends that present process improvement and… more