Remote Appeals Clinician I — RN
Cambia Health Solutions
- Remote job
Cambia Health Solutions is seeking an Appeals Clinician I to leverage clinical expertise in assessing appeal types, ensuring compliance with medical policies. This remote position is open to candidates residing in Oregon, Washington, Idaho, or Utah. The ideal candidate will have a Bachelor's Degree in Nursing, an active RN license, and at least 3 years of clinical experience. Join us in making health care easier and enhancing member health journeys. #J-18808-Ljbffr Cambia Health Solutions
- Cambia Health Solutions is looking for an Appeals Clinician I to join their Clinical Services team. This role focuses on ensuring compliance with medical policy through clinical appeal reviews. Ideal candidates will have a Bachelor's Degree in Nursing and essential clinical...Remote jobWork from home
$76.5k - $103.5k
Cambia Health Solutions is looking for an Appeals Clinician I, focusing on resolving member appeals with your clinical expertise. You will ensure... ...have a Bachelor's Degree in Nursing along with an active RN license. The role offers a competitive salary, with the expected...Remote jobWork from homeFlexible hours- Cambia Health Solutions is looking for an Appeals Clinician I to work remotely from Oregon, Washington, Idaho, or Utah. This critical role will utilize... ...candidate has a Bachelor’s Degree in Nursing, an active RN license, and at least three years of relevant clinical experience...Remote job
$76.5k - $103.5k
Cambia Health Solutions is seeking an Appeals Clinician I to utilize clinical expertise in resolving member and provider appeals. This role is... ...members and requires a Bachelor's Degree in Nursing, an active RN license, and relevant clinical experience. The expected salary...Remote job$76.5k - $103.5k
...Appeals Clinician I Work from home within Oregon, Washington, Idaho or Utah Build a career... ...outcomes that matter most to them? Are you an RN who finds yourself asking 'why' when a... ...appeals staff on clinical cases. #LI-Remote Pay ranges vary based on the...Remote workFull timeImmediate startWork from homeFlexible hours- ...Registered Nurse Clinician Twin Cities Spine Center is a nationally... ...closely with Prior Authorization on appeals for surgical cases... ...experience preferred Active RN License Certification in Basic... ...Minneapolis with rotation to remote clinics as business dictates...Remote workFull timeTemporary workWork at officeMonday to FridayFlexible hours
$68.97k - $113.31k
...The Senior RN Clinical Consultant will work in partnership with... ...lines of business (STD/LTD/Appeals) and products, action planning... ...ideas for improvement Support Clinicians in developing efficient desk &... ...Location This is a remote position with occasional travel...Remote workFull timeVisa sponsorshipWork visaFlexible hours$95k - $110k
...DRG Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most... ...guidelines; successfully completes required CEUs to maintain RN license and/or coding certification. Responsible for attending...Remote workFull timeWork from homeRelocation packageFlexible hours- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching...Remote job
- Crains Cleveland is seeking a Clinical Appeals RN responsible for attending appeal hearings and defending MassHealth prior authorization decisions. The position offers the opportunity to telecommute and requires candidates to reside in Massachusetts. Ideal candidates will...Remote job
- The University of Minnesota School of Nursing is hiring a Clinical Appeals RN to manage appeal hearings and defend MassHealth's prior authorization decisions. This role requires individuals who reside in Massachusetts, with an opportunity to telecommute. Key qualifications...Remote jobFlexible hours
$29 - $52 per hour
UnitedHealth Group is seeking a Remote Registered Nurse (RN) in California to handle appeals and medical record reviews. The ideal candidate should possess a current RN license and have at least 2 years of clinical experience. This role also requires familiarity with Medicare...Remote jobHourly pay- Stryker Corporation is looking for a Clinical Appeals RN in Massachusetts to represent MassHealth at appeal hearings and defend prior authorization decisions. The ideal candidate will have clinical experience, an RN license, and strong communication and time management...Remote job
$88.85k
...Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position... ...work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical...Remote workFull timeShift workWeekend work$29 - $52 per hour
UnitedHealth Group is seeking a Clinical RN to conduct appeals assessment and care reviews. This role offers the flexibility to work remotely, adhering to Eastern or Central Standard Time. Candidates must have valid RN licensure and at least 2 years of clinical experience...Remote jobHourly pay$90k - $99k
...healthcare solutions provider seeks a DRG Nurse Reviewer Appeals and Hearings to coordinate appeal duties and engage... ...virtual and on-site. Candidates must have an active RN license and coding certification. This remote role offers flexibility and opportunities for career...Remote jobFlexible hours- ...Appeals Processor III - RN ~ salary ~ Unavailable ~ Hours per week ~40 ~ Shifts ~5/8's ~ Start Date ~ Unavailable ~ Duration... ...Appeals Processor III (APP III) to join our dedicated team in a remote capacity. The Appeals Processor III (APP III) is...Remote workContract workFor contractorsFor subcontractorShift work
$29 - $52 per hour
Texas Health Institute is seeking a motivated RN to assess appeals and medical records, ensuring coverage and billable criteria. This role offers remote work flexibility, primarily within EST and CST hours. The candidate should have a valid RN license, 2+ years of clinical...Remote jobHourly pay$66k - $68k
WPS—A health solutions company is seeking an Appeals Nurse to examine medical records and claims for first-level appeal cases. This role... ...salary range of $66,000-$68,000 depending on experience, with remote work options available in several states. Excellent...Remote job$28.94 - $51.83 per hour
Texas Health Institute is hiring a Clinical Appeals RN to represent MassHealth at appeal hearings and perform clinical coverage reviews. The successful candidate must have an unrestricted RN license in Massachusetts and at least 3 years of managed care or clinical experience...Remote jobHourly pay$52 per hour
...Hiring for RN - Appeals (Remote Role) in Somerville, MA Shift: Days 5x8 (08:00 - 17:00) Duration: 13 Weeks (Temp to Perm) Pay Rate: $52/hr on W2 ($2,080/WK) OT: $78/hr after 40hrs weekly Requirements: ~ MA RN License, BLS (AHA) ~100% remote ~ Looking for...Remote jobPermanent employmentTemporary workShift work- HealthEdge is seeking an experienced clinical professional to manage appeals and grievances in a remote setting. The role involves investigating requests from members and providers and ensuring compliance with regulations. This position requires a Bachelor's degree, a...Remote job
- The Elevance Health Companies, Inc. is seeking a Nurse Appeals RN-Quality of Care based in Metairie, Louisiana. The role involves investigating medical necessity appeals and reviewing member grievances to ensure timely resolutions. Applicants must have a current RN license...Remote jobFull time
$38.17 - $57.25 per hour
...Nurse Appeals-RN (California) Nurse Appeals RN Locations: Woodland Hills, CA and Costa Mesa, CA Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This...Remote workFull timeTemporary workWork at officeLocal area1 day per week- A leading healthcare provider is seeking a remote Worker’s Compensation Telephone Triage Clinician. This full-time position requires an unencumbered RN license and three years of recent RN experience. Ideal candidates should be bilingual in Spanish and comfortable working...Remote jobHourly payFull timeNight shift
- ...Behavioral Health Clinician Competitive Compensation & Benefits Package! Position eligible... ...Qualifying Employer Location: Remote Option in NC (or within 40 miles of NC border... ...Licensed Clinician or Registered Nurse (RN) and two years of clinical experience in...Remote workContract workLocal areaImmediate start
$71.59k - $116.48k
...Clinical Specialist to manage health member complaints and appeals. This fully remote position requires expertise in clinical case management, understanding... ...cases independently. The ideal candidate should be an RN, LPN or Dental Hygienist with experience in appeals....Remote job- ...Job Title: Registered Nurse - Claims & Appeals Review Location: Remote (Anywhere in Florida) Duration: 06... ...improvement opportunities. Collaborate with clinicians and MD reviewers to validate... ...platforms Licensure/Certification Valid RN, LPN, or LVN license in applicable state...Remote workContract workDay shift
- ...review of prospective, retrospective, and concurrent review of appeals for denied prior authorizations. Includes standard and expedited... ...combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice....Remote jobWork at office
- ...seeking a Registered Nurse for Claims & Appeals Review. This remote role supports compliance and quality... ...Bachelor's degree in healthcare and valid RN license in Florida. Key... ...conducting audits, and collaborating with clinicians. This position offers the opportunity...Remote job
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