• Clinical Coding Appeals

    R1 RCM (Detroit, MI)
    …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you ... this remote production-drive position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical… more
    R1 RCM (12/13/24)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Ann Arbor, MI)
    …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... Medical Surgical, or Pediatrics. Advanced Practice Nursing. Billing and coding experience. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical more
    Molina Healthcare (01/18/25)
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  • Prior Authorization Specialist RN PRN

    Intermountain Health (Lansing, MI)
    …requests and/or review of denials to ensure medical necessity, payer policies, appeals and reconsideration needs. Promotes the quality and cost effectiveness of ... patient care using clinical acumen in preparation of documentation, audits of patient...prior authorization, pre-determination and/or dispute denials via retro authorization, appeals or reconsiderations related to no authorization denials +… more
    Intermountain Health (01/18/25)
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