- Elevance Health (Topeka, KS)
- ** Nurse Appeals ** **Location:** This position will work a hybrid model (remote and office). Candidates must reside in Olathe, KS, Topeka, KS, or Overland Park, ... KS. The ** Nurse Appeals ** role is responsible for investigating and processing and medical necessity appeals requests from members and providers. **How you… more
- Prime Therapeutics (Topeka, KS)
- …and drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description Summary** Under supervision, is responsible for performing ... web-based application and spreadsheets. + Supports clinical services such as the appeals program. + Participates in meetings and consults with management on regular… more
- Ascension Health (Manhattan, KS)
- …related to coding, medical records/documentation, precertification, reimbursement and claim denials/ appeals . + Assess and coordinate discharge planning needs with ... **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing required. Education:… more
- Sharecare, Inc. (Topeka, KS)
- …enrollment / new hire plan selection, claims issues, ID card issues, grievances/ appeals , utilization management (UM) status, including but not limited to medical, ... 3rd parties for: + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status +...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more