Clinical Appeal Specialist (Fully Remote)
Partner Engineering and Science
- Remote job
Investigate denied claims and appeal strategies. Analyze payer policies and trends. Recommend revenue cycle improvements. Requirements: Active RN license and reimbursement knowledge. Medical coding and payer policy experience. Excel, analytical, communication skills. Fully remote-eligible. Partner Company Our partner organization focuses on improving patient outcomes and supporting cancer care. They are a collaborative remote team blending clinical, financial, and administrative expertise. #J-18808-Ljbffr Partner Engineering and Science
$66.54k - $101.5k
...applications and next steps. Our partner is looking for a Clinical Appeal Specialist based in the United States. As a Clinical Appeal... ...knowledge, analytical thinking, and attention to detail in a fully remote-eligible position. \n Accountabilities Coordinate...Remote workHourly payDaily paidFull timeWork at office- NTT DATA, Inc. is seeking a Clinical Reviewer Specialist to perform clinical and medical necessity reviews to support appeals processing. You will evaluate medical records and... ...Medicaid, and state regulations. The role is fully remote within Florida, requiring 3 years of...Remote job
- Partner Company is a remote-focused organization dedicated to improving patient outcomes... ...evaluating denied claims and developing appeal strategies. The candidate brings an active... ...improvements across the revenue cycle in a fully remote setup. #J-18808-Ljbffr Partner...Remote job
$73.4k - $120.36k
Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst... ...of or delivery of clinical and non-clinical services. A&... ...manner. The A&G Clinical Specialist is the subject matter expert... ...providers. This is either a remote or on-site position located at...Remote workFull timeContract workTemporary workWork experience placementLocal area$108.51k - $196.41k
...Job Description Summary The Appeals team oversees all operational and clinical aspects of the appeals process,... ...accreditation standards. The Appeal Clinical Specialist is responsible for independently... ...company location (or from a remote location with management approval...Remote workFull timeWork at officeLocal areaMonday to FridayNight shiftWeekend work- ...firstsourc is seeking a Clinical Denials Specialist for a remote role in the United States. You will manage denials related to referrals, authorizations, and medical necessity, and prepare timely appeals. The position emphasizes accurate documentation and compliance with...Remote work
- ...Priority Management is seeking a Clinical Appeals Specialist to perform comprehensive clinical reviews and prepare supporting medical records for... ...information from EHRs, and coordinate with teams in a remote, production-oriented environment to meet strict deadlines....Remote work
- ...company’s established privacy policies and procedures; The Clinical Appeals Specialist is responsible for the comprehensive clinical review and... ...audit and appeal deadlines, and works independently in a remote settingQuality - Demonstrates accuracy and thoroughness; excellent...Remote work
- Centene Corporation is seeking an Appeals Liaison to act as the statewide contact for appeals, fair hearings, and external reviews. This remote role requires WA licensure and aligns with NCQA standards, with hours 8:00 am-5:00 pm PST, Monday-Friday. The role emphasizes...Remote jobMonday to Friday
$76k
...Position Summary The Clinical Reviewer Specialist is responsible for performing clinical and... ...accurate processing of member and provider appeals. This role evaluates medical records... ...required benefits. Position is fully remote only in the state of Florida. Must...Remote workPermanent employmentFull timeTemporary workLive inImmediate startRelocationFlexible hours$66.54k - $101.5k
...administration and coordination of the denials review and appeals management processes that includes denials management, claims... .... **Accommodation: LPN's currently in the role of Clinical Denial Specialist will be given a specified time frame (2 years) to obtain the...Daily paidFull time$81.1k - $116.48k
Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote Join to apply for the Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote role at Healthfirst . Position Summary: The Appeals & Grievances (A&G) unit...Remote jobFull timeMonday to FridayShift work$40 - $46 per hour
...Solutions is immediately hiring for a RN Clinical Appeals Specialist Position type: Full time Contract... ...Location: Philadelphia PA 19103 (Remote) As a RN Clinical Appeals Specialist... ...operations including HMO PPO self-funded fully insured commercial government program...Remote workHourly payFull timeContract workTemporary workFor contractorsWork experience placementWork at officeImmediate startWorldwideFlexible hours$105 per hour
...Compensation: $105/hour Location: Remote Role Responsibilities Manage end-to... ...authorisation workflows for medical and clinical services across multiple payer types.... ...Track authorisation status, denials, and appeal outcomes to identify workflow improvement...Remote jobContract workSummer workWork at office- ...PHIL Clinical Support Associate Founded in 2015, PHIL is a Series D health-tech startup... ...4060 inquiries per day. In this fully remote position, you will handle inbound calls,... ...prior authorizations, tier exceptions, and appeals Use professionalism, de-escalation and...Remote workWork at office
$52k - $270.4k
Clinical & Health Specialist Remote Role Role/Domain | Exp | Geo Utilization Management Nurse | 3y Clinical Social Worker | 3y Quality... ...education, utilization management, prior authorization, payer appeals, medical coding, CDI, infection prevention, NHSN...Remote workFull timePart timeFor contractors$100k - $120k
...Job Location / Type This is a remote, field-based role supporting a high volume... ...inform effective patient programming during clinic visits. Train new customers on the... ...basis until this position is filled. For fully remote positions, compensation will comply...Remote workMinimum wageOngoing contractFull timeWork at officeLocal areaWorldwideNight shift- ...health accreditation organization is seeking a Part-Time Clinical Review Specialist who will play a key role in supporting accreditation processes... ..., and a background in quality assurance. This role is fully remote, allowing candidates from anywhere in the United States...Remote workPart time
$16 - $24 per hour
...Clinical Reimbursement Specialist Support Care. Strengthen Access. Make a Real Impact. The Visiting Nurse Association Health Group (VNAHG... ...organizational skills Working Conditions/Physical Demand: Fully remote position within a fast-paced department with phone and...Remote workWork experience placementLocal areaWork from home- ...About the role As a member of the Clinical AI Specialist team at Generator Health, you will use your managed care expertise to optimize the... ...care work in prior authorization, utilization management, appeals, or clinical quality at a health plan, pharmacy benefit manager...Remote workFull time
- ...Clinical Denials Specialist Role: Clinical Denial Specialist Schedule: M - F 8 AM - 4:30 PM EST GENERAL SUMMARY: The goal of the Clinical Denial... ...for claim resubmission, retro authorization, written appeal or if no action is needed. The Clinical Denial Specialist...Remote workContract workLocal area
- ...very welcoming and supportive environment; where everyone can thrive. About the Job: The Nurse Appeals Specialist is responsible for completing a thorough evaluation of clinical documentation to support the resolution and prevention of payer denials. This position will...Permanent employmentWork at officeShift work
- ...Soleo Health is seeking an Infusion Clinical Review Coordinator to support our Specialty Infusion Pharmacy and work remotely in the USA. This role focuses on researching and... ...denials. You will use national criteria for appeals and collaborate across departments. Must...Remote work
- SolutionHealth in Manchester, NH seeks a Nurse Appeals Specialist to evaluate clinical documentation and support the denial appeals process. You will work with clinical and revenue cycle teams to reduce denials and improve revenue integrity. The role involves reviewing...
$68.64k - $74.88k
...Overview The Clinical Data Quality Specialist is a critical member of the Client Services team, providing support to the clinical leads, abstractors... ...competitive pay, full-time* team members enjoy: ~ A fully remote work environment with flexible schedule and a generous...Remote workHourly payFull timeTemporary workFlexible hours- ...Clinical Implementation Specialist This is a remote position. Position Summary The Clinical Implementation Specialist is responsible for providing external... ...independently and within a team environment Benefits Fully Remote Workforce As a virtual-first organization, we...Remote workWork experience placement
$75k
...Unless otherwise noted, all positions are fully remote with work permitted from the following... ...of your phone. Our in-house clinical care team, composed of board certified... ...smoothly. As our Clinical Operations Specialist, you'll own that engine: the clinical...Remote workFull time- ...Owning the operational coordination of clinical schedules and coverage, the full-time Clinical Operations Specialist will manage day-to-day operations across multiple states in a fully remote environment, ensuring smooth healthcare delivery and supporting the clinical...Remote workFull time
- ...Remote Appeals Pharmacist Fair Medication Access Work From Home | Strong Clinical Writing Focus Combine clinical expertise with advocacy in a fully remote Appeals Pharmacist role. Review medication coverage appeals, apply evidence-based guidelines, and ensure fair...Remote jobWork from home
- ...Seeking a skilled Clinical Application Specialist I for a fully remote, one-year contract role, where the candidate will support Real-World Data (RWD) and Real-World Evidence (RWE) analyses, focusing on AI-driven data initiatives and obesity research. Key responsibilities...Remote workContract work
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