- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you will help ... remote production-drive position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to… more
- R1 RCM (Detroit, MI)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Supervisor** , you will help support clinicians ... position. **Here's what you will experience working as a Clinical Appeals Supervisor:** + Track and monitor...additional support and engagement. **Required Skills:** + Active Registered Nurse license For this US-based position, the base pay… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals and Denials Manager** , you will serve as ... an expert on clinical appeals and denials management. Every day...challenges, and process improvement opportunities. **Required Skills:** + Registered Nurse (active or inactive in good standing and able… more
- Molina Healthcare (Detroit, MI)
- …national, state, and local laws and regulatory requirements affecting the medical and clinical staff. ** Schedule: 30 hrs **Job Duties** + Provides medical oversight ... medical necessity. + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the investigation of adverse… more
- University of Michigan (Ann Arbor, MI)
- …care areas. The position is unique in that it combines clinical /quality considerations with regulatory/financial/utilization review demands. The position creates a ... balance between individual clinical needs with the efficient and cost effective utilization...Cycle/HIM regarding RAC decision to appeal, denials; input into appeals ; share findings with providers + Review all cases… more
- Corewell Health (Royal Oak, MI)
- …criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization ... adult and Level II pediatric trauma designations. The advanced capabilities and clinical expertise within this center have earned it Magnet designation four… more