Remote RN Clinical Denials & Appeals Specialist
Huron Consulting Group Inc.
- Remote job
Huron Consulting Group Inc. is looking for a Clinical Denials Auditor in Chicago. The successful candidate will manage denials and appeals effectively, ensuring compliance with healthcare regulations. Responsibilities include reviewing denied claims, submitting timely appeals, and collaborating with management to improve denials processes. The role requires a Bachelor of Science in Nursing and significant clinical experience, with an emphasis on communication and analytical skills. A competitive hourly rate and benefits are provided. #J-18808-Ljbffr Huron Consulting Group Inc.
$35 - $63 per hour
...experienced healthcare coder to analyze DRG Appeals, prepare written appeals, and... ...The role requires an unrestricted RN license and extensive knowledge of ICD-10 coding as well as clinical judgment. Enjoy the flexibility to work remotely from anywhere in the U.S., with...Remote jobHourly payWork at officeLocal area$43.03 - $62.5 per hour
Boston Medical Center (BMC) is seeking a Denials & Appeals Administrator (RN) to oversee the appeal process and manage utilization reviews. This role combines clinical, business, and regulatory skills while collaborating with physicians and payers to maximize reimbursements...SuggestedHourly pay- Direct Jobs is seeking a qualified Denial Review & Analysis professional in Morristown... ...denials, writing evidence-based appeal letters, and collaborating with... ...ideal candidate will have an active NJ RN license and substantial clinical experience. The position offers...Suggested
- ...Morristown, NJ is hiring for a Denial Review & Analysis role... ...an active NJ Registered Nurse (RN) license. Responsibilities include... ...reviewing payer denials, writing appeal letters, and collaborating... ...ideal candidate has 3-5+ years of clinical experience, preferably in...SuggestedFull timeShift work
- Boston Medical Center is seeking a full-time RN Appeal Administrator responsible for managing the pre-denial and denial processes in healthcare services. This role... ...collaboration with payers and ensures the clinical appropriateness of patient care levels. The ideal...SuggestedFull time
- A healthcare solutions firm is looking for a Clinical Appeals Nurse (RN) to support revenue cycle operations by reviewing denied claims. This remote position requires an active RN license and 3-5 years of clinical nursing experience. Responsibilities include assessing medical...Remote work
- Atlantic Health is looking for a Denial Review & Analysis specialist to handle payer denials and appeals. Key responsibilities include reviewing medical... ...candidate must possess an Active NJ RN license along with 3-5 years of clinical experience, preferably in acute care....
- ...System is seeking a full-time Hospital Appeals Specialist (RN) in Morristown, NJ. In this role, you... ...will be responsible for reviewing payer denials, developing appeals, and collaborating... ...license, have a strong background in clinical experience, and be skilled in writing...Full time
- Atlantic Health is seeking a Hospital Appeals Specialist (RN) for a full-time position with shifts from 8... ...NJ. This role focuses on managing payer denials and developing strong appeal letters through collaboration with clinical teams and adherence to payer policies. The...Full timeShift work
- ...Morristown, NJ, is seeking a Hospital Appeals Specialist (RN) to join their Revenue Cycle Integrity... ...reviewing and appealing medical claims denials, collaborating with physicians, and... ...New Jersey RN license and 3-5 years of clinical experience, preferably in acute care....
- MVP Health Care is seeking a Clinical Appeals RN to ensure fair and timely review of healthcare service denials. This role involves analyzing medical records and clinical documentation and collaborating with medical directors to decide on appeals. The ideal candidate will...Remote job
- Blue Cross Blue Shield of Arizona needs a clinical expert for managing member and provider appeals. This remote position requires strong accuracy, knowledge of compliance timelines, and a focus on customer service. Applicants should possess a healthcare-related degree and...Remote job
$69.38k - $92.28k
Overview As a Clinical Appeals RN, you will review denied service authorizations and claims, evaluate... ..., and recommend whether the denial should be overturned Collaborate with MVP... ...performed in a combination of office and remote settings. EEO Statement MVP is an equal...Remote workWork at office- 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
- TeamHEALTH is looking for a Denials and Appeals Representative to handle denials and appeals for patient accounts in a cooperative team environment. The ideal candidate has at least two years of experience with insurance denial processes. Responsibilities include processing...Remote job
- Aspirion is looking for a Denials Appeals Specialist in Delray Beach, Florida. This role involves analyzing denied claims, drafting appeal letters, and working to improve cash flow and minimize revenue leakage. The ideal candidate has strong analytical skills, great communication...Remote job
- ...General Hospital is searching for a Senior Denials Specialist for the comprehensive review, analysis,... ...of denied hospital claims through the appeals process. You'll work to ensure optimal... ...work model to balance on-site and remote work. #J-18808-Ljbffr Tampa General HospitalRemote work
- ...Denials Specialist Insight Global is seeking a fully remote Denials Specialist to support a Healthcare AI client. This is a part-time opportunity working approximately... ...where candidates will leverage their denials and appeals expertise to evaluate and improve AI-driven...Remote workContract workPart timeMonday to FridayFlexible hoursShift workWeekend work
- ...Clinical Supervisor, UM Denial Compliance Location: Los Angeles Metropolitan Area... ...Position Type: Hybrid (85% remote, 15% onsite in Burbank, CA)... ...Registered Nursing Program; RN preferred. Minimum of five... ...in prior-authorization, appeals & grievance, or health plan...Remote workPermanent employmentTemporary work
- Payfuture Technologies is seeking an Appeals and Grievance Registered Nurse to manage clinical appeals and handle communication with healthcare teams regarding denial rationales. Responsibilities... ...Associate's Degree in Nursing and an RN License. The position is full-time...Full time
- ...Clinical Appeals Nurse (RN) Status: Exempt Location: Remote Department: Clinical Appeals Reports To: Director of Clinical Appeals Position Overview... .... This role plays a critical part in overturning denials, improving reimbursement outcomes, and ensuring compliance...Remote work
- ...including but not limited to, appeals, insurance website inquiries,... ...with site resources to ensure denials are appealed timely and submitting... .... Employees approved for remote work are expected to maintain... ...relationships with team members, clinic staff and patients. Have a desire...Remote workFull timeWork from homeShift workNight shift
$50 per hour
...A leading healthcare staffing firm is seeking an experienced RN Clinical Reviewer to work remotely. You'll conduct detailed medical-legal reviews and appeals while maintaining high accuracy and integrity. Key qualifications include a New York State RN license and at least...Remote work- ...consulting firm is expanding its team by hiring a Clinical Appeals Review Nurse. This role involves completing clinical denial reviews, performing various audit services, and... .... Required qualifications include an RN certification, experience with DRG denials, and...
$102k - $158.39k
Beth Israel Lahey Health, Inc. is looking for a Clinical Documentation Specialist II- RN to work remotely from Massachusetts. This position involves reviewing inpatient records for completeness and accuracy, improving physician documentation, and collaborating with various...Remote job$35 - $63 per hour
Crains Cleveland is looking for a Senior Clinical Appeals RN who utilizes expertise in MS-DRG and APR-DRG auditing to respond to appeals and coach remote DRG Validation Specialists. This role allows for remote work across the U.S., with specific location requirements for...Remote jobHourly pay$38.17 - $57.25 per hour
Elevance Health is seeking a Nurse Appeals RN to work virtually full-time, with in-person training required. The role involves investigating medical necessity appeals requests and requires a high school diploma and 2+ years of managed care healthcare experience. Candidates...Remote jobFull time- The Elevance Health Companies, Inc. is seeking a Nurse Appeals-RN to manage medical necessity appeal requests. The position allows for virtual work full-time with in-person training required. Successful candidates will investigate appeals, review medical records, and provide...Remote jobFull time
- Elevance Health is looking for a Nurse Appeals - Licensed Nurse based in Louisville, KY. The role requires conducting investigations, reviewing... ...recommendations for decisions. Candidates need a current RN license and a minimum of 2 years' experience in managed care. The...Remote jobFlexible hours
$35 - $63 per hour
...of State and Territorial Epidemiologists is hiring a Senior Clinical Appeals RN. This position utilizes expertise in MS-DRG and APR-DRG auditing... ...2 years of experience in ICD-10 coding. The role allows for remote work, and candidates should be solution-oriented problem...Remote jobHourly pay
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