Remote RN Care Manager: Appeals & Denials Specialist
Providence
Torrance, CA
- Remote job
Providence California Regional Services is hiring a remote Care Manager RN on a per diem basis for 8-hour day shifts. The Care Management Recovery Advocate will coordinate clinically-based appeals between Providence and outside payers, with a focus on patient-centered, compliant advocacy for reimbursement of services. Required: California RN license, an Associate's degree in Nursing, 4 years of direct patient care in an acute hospital, and 4 years as a case manager in an acute setting. #J-18808-Ljbffr Providence
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote RN Care Manager: Appeals & Denials Specialist in Torrance, CA vacancy
- Providence California Regional Services is seeking a Care Manager RN for a remote, full-time role. The position involves day shifts and focuses on coordinating clinically-based appeals and reimbursement processes for patients across PH&S California regions. Candidate must...Remote jobFull timeDay shift
- Providence Jobs in California is seeking a Care Manager RN for a remote per diem role with 8-hour day shifts. The CMRA coordinates clinically-based appeals between Providence Health & Services, California Region, and external payers, focusing on patient-centered, compliant...Remote jobDaily paidDay shift
- UT Southwestern Medical Center is seeking a Technical Denials Management Specialist II in the Revenue Cycle Department to review, research, and resolve claim denials and appeals for various insurers, while identifying payment trends to maximize collections. This WFH role...Remote jobWork at officeWork from home
- A leading healthcare staffing firm is seeking a detail-oriented individual for managing medical necessity appeals and claims reviews. The role involves reviewing cases, preparing documentation for the Medical Director, and ensuring compliance with NCQA guidelines. Candidates...Suggested
- Harris Health System, Inc. in Houston is seeking a Care Manager Clinical Denials (CM-CD) to manage clinical audits and denials related to inpatient... ...apply clinical and payor knowledge, and coordinate timely appeals as required. The CM-CD will serve as a liaison between...Suggested
- 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 work
Healthfirst
United States3 days ago - VitalConnect, Inc. is seeking a Denial Management Specialist on a fully remote basis to join the Revenue Cycle team. You will investigate complex third-party insurance denials and optimize reimbursement by researching and acting quickly on denials. The role requires 3+...Remote job
- Guardant Health, Inc. is seeking a Reimbursement Specialist II, Follow-Up and Appeals to drive reimbursement outcomes within the revenue cycle. You will analyze EOBs, prepare appeals, and maintain payer communications while supporting patient billing needs. The role emphasizes...Remote job
- ...provider groups and hospitals. As a Denials & Appeals Specialist , you will investigate denied healthcare... ...attention to detail and ability to manage multiple claims and deadlines ~... ...and ability to work independently in a remote environment ~ HIPAA-compliant private...Remote workFull time
CareerSwift
Remote19 days ago - ...to all assigned levels of denials by submitting appeal letters and required documentation... ...the denial overturned. Remote: Although this position is... ...manner and/or reporting to management when assistance is needed... ...Knowledge of managed care industry including payer structures...Remote work
Quadax
United States3 days ago - ...RN CASE MANAGER – CARE MANAGEMENT DEPARTMENT - University of New Mexico Hospital – Albuquerque... ...hospitalized. They provide provider support, appeals and denials and work directly with insurance... ...interaction. · Primarily a remote work from home position once applicant...Remote workFull timePart timeReliefWork from homeRelocation packageMonday to FridayNight shiftDay shiftAfternoon shiftWeekday work
University of New Mexico
Peralta, NM4 days ago - ...Monday-Friday 8am-4:30pm Remote Summary: The Denial Coding Specialist supports the Revenue Recovery team... ...EPIC work queues daily for Denial management and makes necessary and appropriate... ...# Coordinates and/or completes appeals as applicable with payors. #...Remote workFull timeMonday to Friday
Akron Children's Hospital
Akron, OH3 days ago - ...Denials Specialist Insight Global is seeking a fully remote Denials Specialist to support a Healthcare AI client. This is... ...will leverage their denials and appeals expertise to evaluate and improve... ...effective real-world denial management practices Analyze and explain successful...Remote workContract workPart timeMonday to FridayFlexible hoursShift workWeekend work
Insight Global
Palo Alto, CA5 days ago $119.14k - $184.95k
...Care Manager RN- REMOTE position. This position is Per Diem and will work 8- hour, Day shifts.... ...and communication of clinically-based appeals between Providence Health and Services... ...certification Experience working with denials and appeals in/for an acute care setting...Remote workDaily paidMinimum wageLocal areaShift workDay shift- ...The full-time Denial Management Specialist will manage denial and accounts receivable (AR) processes remotely, focusing on resolving outstanding denials, initiating insurance appeals, and identifying denial trends to improve future claims processing. Key responsibilities...Remote workFull timeWork at office
Virtual Vocations Inc
United States4 days ago $21.16 - $38.37 per hour
...to apply for the Medicare Appeals & Grievances Specialist (PST Hours) role at... ...Healthcare . This position is remote and will be working... ...Qualifications At least 2 years of managed care experience in a call... ...and Medicare claims denials and appeals processing, and...Remote workHourly payFull timeContract workWork experience placementWork at officeMolina Healthcare
Phoenix, AZ2 days ago$36 - $40 per hour
...our own path. We’re a remote-first staffing and consulting... ...in mid-Revenue Cycle management within the healthcare... ...career. If you are an Appeals and Denials Nurse looking for a... ...Our requirements: RN or FMG: CDIP, CCDS, CCS... ...will be from post-acute care facilities. (mostly...Remote workPermanent employmentFull timeWork visa$28.85 - $35 per hour
...engaged to conduct a search for a Denials & Revenue Recovery Specialist for a fast-growing healthcare... .... This is a fully remote role (U.S.-based, any time zone... ...specific workflows. You will manage assigned denial queues, submit appeals, and follow claims through to...Remote workHourly payTemporary workInterim roleFlexible hoursScion Staffing
United States5 days ago- ...Insurance Specialist Medical Data Systems Inc. is seeking a detail... ...status inquiries, and filing appeals for denied claims. Process... ...directed. Assist colleagues and management by providing information or... ...claim submission, claim denials, HCPCS/CPT/ICD-10 coding basics...Remote workFull timeWork at office
Medical Data Systems
United States3 days ago - Quorum Health Corporation is seeking a Revenue Cycle Specialist to perform hospital revenue cycle functions including AR, denial management, and appeals. The role supports remote work with responsibilities spanning insurer communications, patient interactions, and adherence...Remote job
$24.36 per hour
...At Emplify Health, we care for our teams, while... ...changes everything. Denials And Coding Specialist DRG Hospital... ...Inpatient primarily manages payor DRG denials across... ...coding accuracy, supports appeal processes, and ensures... ...), Full-time ~ Remote eligible after first...Remote workFull timeMonday to FridayShift workDay shift- ...are seeking a Registered Nurse (RN) Case Manager to support inpatient and outpatient care management, utilization review,... ...medical necessity, handling appeals, denials, and working with insurance payors... ...workers in both clinical and remote settings. Qualifications Include...Remote workWork at officeLocal areaRelocation packageFlexible hoursWeekend work
- ...Medical Center in Dallas seeks a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals within the Revenue Cycle Department. The role... ..., and work with payors including Managed Care, Commercial, Medicare, and Medicaid to maximize...Remote job
- ...an Insurance Reimbursement Specialist to maximize collections by pursuing unpaid claims and managing multi-level appeals. This full-time role is based... ...in Brisbane, CA, with some remote collaboration for eligible... ...Cycle team, and support denial management while maintaining...Remote jobFull time
- ...seeking a Revenue Cycle Associate - Collections to support hospital revenue cycle activities remotely. The role focuses on insurance accounts receivable, denial management, and appeals to maximize reimbursement while adhering to payer guidelines and organizational policies....Remote job
- ...Medical Billing Workers' Compensation AR Specialist for a fully remote role across the United States. You will manage accounts receivable, billing, claim corrections... .... Responsibilities include WC AR cleanup, denial reviews, appeals with carriers, eligibility verification,...Remote job
$28.72 - $36.92 per hour
...This position is primarily remote, candidates must reside... ...Summary: The AR Follow-Up Specialist III, Coding and Complex Denials is responsible for... ...coding-related denials and appeals in addition to following... ...the unit supervisor and manager with complex cases, supports...Remote jobHourly payFull timeWork at officeLocal area- ...Care Manager Clinical DenialsThe Care Manager Clinical Denials (CM-CD) is responsible for the management of clinical... ...denied and whether an appeal is required. For all inappropriate... ...Clinical Documentation Specialist (CCDS) OR Accredited Case Manager-RN (ACR) specialty...Remote workWork experience placementWork at office
Harris Health System
United States3 days ago - ...Health in Arlington Heights, IL seeks a Denial Management Specialist to review and resolve denied patient... ...certification, authorization, and level of care requirements. In this role you will... ..., Providers and Payers, submit timely appeals, gather medical records, and write...
Endeavor Health Services
Arlington Heights, IL2 days ago - ...Recovery in Plano, TX is seeking an experienced Registered Nurse (RN) to move beyond bedside care into a strategic, analytical role focused on utilization management, clinical review, and denial appeals. You will analyze denied claims, perform medical necessity reviews...
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN Care Manager: Appeals & Denials Specialist. Be the first to apply!
