Senior Clinical Appeals & Claims Lead
Superior Dental Care, Inc.
Superior Dental Care, Inc. is seeking an experienced Senior Clinical Appeals Nurse to supervise staff and oversee medical claim reviews in a hybrid Ohio setting. The role emphasizes regulatory compliance, workflow optimization, and escalation management for complex cases. The ideal candidate holds a BSN, an Ohio RN license, and at least seven years in clinical appeals or health insurance, with demonstrated leadership experience. Join a team focused on accuracy, quality, and compliant practices. #J-18808-Ljbffr Superior Dental Care, Inc.
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Senior Clinical Appeals & Claims Lead in Cleveland, OH vacancy
- Medical Mutual in Ohio seeks a Senior Clinical Appeals Nurse to supervise clinical staff, review complex medical appeals, and ensure compliant utilization management. You will collaborate with physicians, providers, and internal teams to ensure appropriate and timely care...Suggested
$16 per hour
...pertinent information. - 10% Promotes a teamwork philosophy through leading by example and effective communication skills. Leads the work... ...conditions dictate, using an approved method. - 15% Issues claim checks to guests only after receiving vehicle keys and collects...ClaimsHourly payTemporary workPart timeWork experience placementSeasonal workMonday to FridayShift work- Job Description Clinical Strategy & Protocol Development o Lead the development of IRB and clinical study protocols in alignment with company objectives.... ...publications. o Provide clinical evidence to support marketing claims and product positioning. Cross-Functional...SeniorClaims
- The MetroHealth System in Cleveland, OH is seeking a Registered Dietitian to oversee nutritional management and education for patients across divisions. Responsibilities include supervising diet technicians, dietetic interns, and dining service assistants; developing nutrition...Senior
- Applewood Centers is seeking a Supervising Psychologist to lead outpatient psychology services and supervise APA Interns and practicum... ..., psychotherapy, and staff development under administrative and clinical supervision. The role requires a doctoral degree in psychology,...SeniorFull time
- ...experience, including patient access, coding, Clinical Documentation Improvement (CDA), billing,... ...to synthesize complex issues, engage senior leaders, and drive consensusExposure to... ...machine learningStrong analytical skills in claims, productivity, access, and volume data to...SeniorClaimsApprenticeshipEasy work
$16 per hour
...$16-$18 per hour. Additional Cleveland Clinic Opportunities include: Hillcrest Hospital... ...Promotes a teamwork philosophy through leading by example and effective communication skills... ...using an approved method. - 15% Issues claim checks to guests only after receiving...ClaimsHourly payFull timeTemporary workPart timeWork experience placementSeasonal workShift workNight shiftDay shiftAfternoon shift- A national company is seeking an experienced Workers' Compensation Claims Manager to lead the administration of their national workers' compensation program. The role involves overseeing a team, managing complex claims, and ensuring compliance with regulatory requirements...SeniorClaimsFlexible hours
- ...information. Responsibilities Supervises clinical and support staff evaluating medical claims and/or appeal cases and associated records to... ...which includes experience as a Senior Clinical Appeals Nurse or... ...industry. Relevant experience leading teams or projects (formally or...ClaimsWork at office3 days per week
- ...Hospital Care Institute at the Cleveland Clinic is recruiting for senior and mid-career critical care... ...development to join an outstanding team in leading our enterprise to further transform... ...for payment or personal details claiming to come from reputable organizations...SeniorClaimsFull timePart timeLive inWorldwide
- Job Category : Clinical Appeal & Claim Review Posted : July 16, 2026 Full-Time Hybrid Locations... ...Nurse, which includes experience as a Senior Clinical Appeals Nurse or equivalent relevant... ...industry. Relevant experience leading teams or projects (formally or informally...ClaimsFull timeWork at officeRemote work3 days per week
- Sedgwick, Columbus or Dayton, Ohio, is seeking a Sr Adjuster/Marine Surveyor to investigate and adjust property and casualty claims with little to no supervision. The role requires examining policies, preparing cost estimates, interviewing claimants and witnesses, negotiating...SeniorClaims
- ...Insurance Company in Cleveland, OH is seeking an experienced Litigation Specialist to manage litigated and complex auto liability claims. You will handle claim investigations, determine coverage, draft reservations of rights, and coordinate with defense counsel to drive...SeniorClaims
- ...the United States is seeking an experienced attorney to provide legal support to U.S. HR and operations management with a focus on claims management and compliance. The role involves managing labor and employment-related claims, advising on policy updates, and supporting...SeniorClaims
- A leading healthcare system in Cleveland, Ohio is looking for a Clinical Documentation Integrity Manager to oversee day-to-day operations of the CDI program. This role requires strong leadership skills, expertise in documentation integrity, and a commitment to ensuring...
- Cleveland Clinic in Cleveland, Ohio, seeks a Section Head for the Ambulatory Neurology Clinic - Northeast Ohio (NEO) to lead clinical excellence and operational performance across the region. The position combines direct patient care with executive responsibility for a...
$75k - $85k
...Inclusion Program Manager to oversee assessments and care plans for Inclusion and Intervention Classrooms. The role involves supervising clinical teams, ensuring compliance with ABA standards, and fostering a positive work environment. Candidates should have a Master's degree...Full time- A healthcare provider in Cleveland seeks a CDI Manager to oversee day-to-day operations of the Clinical Documentation Integrity program. The ideal applicant will possess a bachelor's degree and at least two years' experience in an acute care setting, along with excellent...Work at office
- Cleveland Clinic is seeking an experienced Physician Assistant or Nurse Practitioner to co-lead the Trauma Service as APRN/PA Manager. Role is roughly 50% clinical and 50% administrative, including rounding in ICU/ED, central lines, chest tube placement and OR assistance...
- Cleveland Clinic is seeking a Section Head for the Ambulatory Neurology Clinic in Northeast Ohio to lead a large team of outpatient neurologists and advanced practice providers. This physician-leader will shape clinical practice, drive access, and ensure high-quality,...
- ...Ohio is seeking a Supervising Psychologist to oversee outpatient therapists and psychology interns. The position involves providing clinical supervision, conducting assessments, and ensuring quality care delivery in mental health services. Ideal candidates should have a...Senior
- TechDigital Group is looking for a skilled individual to manage MarkLogic integration for the MLCOE project. You will lead the AEI Claims team, ensuring timely delivery of Marklogic deliverables and design improvements. Candidates should have 10-14 years of experience in...Claims
- ...Inc. in Cleveland, OH is seeking a Lab Associate III to support specimen processing, labeling, storage and testing activities in a clinical laboratory setting. The role requires preparing samples, assisting licensed personnel, maintaining reagents and equipment, and...Senior
- ...differentiate and scale business growth.You Are:The Integration Lead Architect playing a pivotal role in ensuring that diverse software... ..., Policy Administration, Servicing, Billing & Payments, Claims, Illustrations & Quotes, Advisor/Distributor workflows, and Digital...ClaimsFull timeWork experience placementLive inWork at officeLocal area
$143.96k - $230.32k
Join Cleveland Clinic, where research and surgery are advanced, technology is leading-edge, patient care is world class and caregivers are family. Here, you will work... ...respected healthcare organizations in the world.The Senior Director of Pharmacy provides enterprise...SeniorLocal areaMonday to FridayShift work- Sky Pediatric Dentistry is seeking a Dental Assistant 2 in Cleveland, Ohio, to lead assisting roles in the Pediatric Dental Clinic. The position requires aiding faculty, residents, and student dentists with procedures and providing essential dental care and education to...
- ..., residents, and fellows in designing, analyzing, and reporting clinical and translational research. This role partners with the University... ...joint initiatives. You will apply advanced statistical methods, lead analytical plans, train researchers in biostatistics, and help...Senior
- The University of Minnesota School of Dentistry is seeking a Dental Assistant 2 to lead operations at the Pediatric Dental Clinic. This role involves assisting faculty and residents in dental procedures, maintaining clinical areas, and organizing supplies. The ideal candidate...
$26.5 - $36 per hour
MedVet, located in Cleveland, is seeking an Emergency Veterinary Clinical Supervisor. In this role, you will manage the Clinical Services team, escalate issues to the Clinical Manager, and ensure effective communication during shifts. Successful candidates must have prior...Shift work$101.9k - $173.22k
Cleveland Clinic is seeking a nationally certified Certified Nurse Midwife to join the Hillcrest Hospital APF team. The CNM will deliver full-scope care in outpatient and inpatient settings, including contraception and intrapartum management. Experience with collaborating...Senior
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Clinical Appeals & Claims Lead. Be the first to apply!
Related searches
- clinical research lead Cleveland, OH
- clinical lead Cleveland, OH
- clinical trial lead Cleveland, OH
- senior lead project manager Cleveland, OH
- senior robotics software engineer Cleveland, OH
- senior devops engineer remote Cleveland, OH
- senior sas administrator Cleveland, OH
- senior IT manager Cleveland, OH
- senior implementation consultant Cleveland, OH
- sr project manager Cleveland, OH