- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …Excel in a **fast\-paced, dynamic environment** \. **Our Ideal Candidates will have an RN or Social Work license and:** + **3 years** \- Clinical behavioral health / ... according to policy\. + Performing comprehensive provider and member appeals , denial interpretation for letters, retrospective claim review, special review… more
- Elevance Health (Indianapolis, IN)
- ** Nurse Appeals ** **Location: Indiana** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... an accommodation is granted as required by law. The ** Nurse Appeals ** is responsible for investigating and...preferred. + 3 years of clinical experience as a Registered Nurse is strongly preferred. + Experience… more
- Elevance Health (Indianapolis, IN)
- ** Nurse Appeals RN -Quality of Care** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and...would provide an equivalent background. + Current active unrestricted RN license to practice as a health professional within… more
- CareFirst (Baltimore, MD)
- …complications. **QUALIFICATIONS:** **Education Level:** High School Diploma or GED. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding… more
- CVS Health (Columbus, OH)
- …with heart, each and every day. **Position Summary** CVS Aetna is seeking a dedicated ** Appeals Nurse Consultant** to join our remote team. In this role, you ... will be responsible for processing the medical necessity of Medicare appeals for participating providers. **Key Responsibilities** + Requesting clinical, research,… more
- University of Washington (Seattle, WA)
- …changes impacting revenue cycle **REQUIREMENTS** + Active licensure to practice as a Registered Nurse in Washington State + Bachelor's degree in Nursing + ... Medicine's Patient Financial Services Department** has an outstanding opportunity for a **Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + 100% FTE +… more
- Evolent (Springfield, IL)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
- State of Colorado (Denver, CO)
- …III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5190465) Apply Registered Nurse Health Compliance Inspector, Complaints ... Registered Nurse Health Compliance Inspector, Complaints...Section - FAA00731 (HP III RN ) Salary $80,916.00 Annually Location Denver, CO Job Type… more
- State of Colorado (Golden, CO)
- Registered Nurse I, RN I...of the department's action. For more information about the appeals process, the official appeal form, and how to deliver ... Mountain, Youth Services Center - Golden Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5185059) Apply Registered Nurse I, RN I -… more
- State of Colorado (CO)
- CDOC Registered Nurse ( Nurse I) Print...RN license. 07 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5123731) Apply CDOC Registered Nurse ( Nurse I) Salary $7,591.00 - $10,627.00 Monthly… more
- Sacramento County (Sacramento, CA)
- Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply Supervising Registered Nurse ... 5:00 pm on: 12/1/25, 2/2/26, 4/6/26, 6/1/26, 8/3/26, 10/5/26, 12/7/26 Supervising Registered Nurse - Detention/Correctional Facility is the first level… more
- Sacramento County (Sacramento, CA)
- …read and understood the above instructions. 02 Select the one box that best describes your Registered Nurse ( RN ) license issued by the State of California. + ... Registered Nurse D/CF (Level I/II) Print...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- State of Colorado (Pueblo, CO)
- Nurse I - Registered Nurse ...if your application is eliminated. You will find the appeals process, the official appeal form, and how to deliver ... - CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5187654) Apply Nurse I - Registered Nurse I - CMHHIP Salary $43.80 - $61.31… more
- State of Colorado (Pueblo, CO)
- Registered Nurse II- CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5187078) Apply Registered Nurse II- CMHHIP Salary ... listed. + Description + Benefits + Questions Department Information Registered Nurse II-Full Time CMHHIP This posting...if your application is eliminated. You will find the appeals process, the official appeal form, and how to… more
- State of Colorado (Denver, CO)
- Registered Nurse I-Colorado Mental Health Hospital in Fort Logan-Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5197088) Apply ... Registered Nurse I-Colorado Mental Health Hospital in...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- LA Care Health Plan (Los Angeles, CA)
- …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category:...as assigned. Education Required Associate's Degree in Nursing for Registered Nurses Education Preferred Bachelor's Degree in Nursing for… more
- State of Arkansas (Little Rock, AR)
- REGISTERED NURSE MANAGER Date: Jan 7, 2026 Req ID: 54815 Location: Little Rock, AR, US, 72202 Category: AR DEPT OF HUMAN SERVICES Anticipated Starting Salary: ... can be with short notice. *Must be a licensed Registered Nurse in good standing with the...timely. This position will maintain data reporting for all appeals , including standard information on the facility and specific… more
- St. Luke's University Health Network (Allentown, PA)
- …Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. . ... of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding… more
- Cedars-Sinai (CA)
- …as a condition of continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K ... Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate policy. + Begins… more
- Actalent (Atlanta, GA)
- …weekends) About the Role We are seeking a detail-oriented and compassionate Utilization Review Registered Nurse ( RN ) to join our team. In this role, ... coordinators, case managers, providers, members, and internal teams (claims, benefits, appeals , risk management). Required Qualifications + Active RN license… more
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