- R1 RCM (Boise, ID)
- …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Nurse ** , you will help our ... remote, production-driven position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct a detailed review of patient medical… more
- R1 RCM (Boise, ID)
- …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
- Sharecare, Inc. (Boise, ID)
- …or assist member in working with payer to complete prior authorization or appeals process, when necessary. + Abide by Clinical Advocacy Program Description ... for everyone. To learn more, visit www.sharecare.com. **Job Summary:** The Clinical Advocate supports the implementation and delivery of Sharecare's Advocacy program… more
- Prime Therapeutics (Boise, ID)
- …and enters data of these cases in web-based application and spreadsheets. + Supports clinical services such as the appeals program. + Participates in meetings ... provided by the Manager, Patient Programs. **Responsibilities** + Registered Nurse (RN). + 5 years of post-degree clinical... Nurse (RN). + 5 years of post-degree clinical experience. + Experience in managed care, specialty drugs,… more
- Sedgwick (Boise, ID)
- …codes and/or technical bills. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Applies clinical editing. + Reviews operative reports to determine if surgery services ... to obtain additional or missing information. + Handles provider appeals as appropriate to fee schedule and contractual disputes....two (2) years of experience in daily application of nurse auditing, utilization review and bill review. **Skills &… more