- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …is eligible for the eWorker persona.The TeamAs an integral part of the Clinical Appeals team, the Appeals Nurse Reviewer will serve as a liaison and ... healthcare? Bring your true colors to blue. The RoleThe Appeals Nurse Reviewer is responsible for reviewing...Payment Policy teams. Key Responsibilities: + Review provider claim appeals utilizing sound clinical judgement, medical policy,… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- …a Bachelors of Science in Nursing program required. + Minimum of 3 years of clinical experience as a Certified Professional Coder required. + Three to five years ... + GENERAL SUMMARY + The Revenue Integrity Nurse Auditor is responsible for the auditing and...supporting documentation, as well as facilitates the completion of appeals in a timely manner. + Prepares trend and… more
- Molina Healthcare (Columbus, OH)
- …Billing and coding experience. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical Coder , Certified Medical Audit Specialists, Certified Case ... resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical … more