Clinical Appeals RN - Medicaid Appeals Specialist
HealthCare Support
A leading healthcare staffing agency is seeking a Clinical Appeals RN in Syracuse, NY. This role involves performing clinical appeals in accordance with Medicaid guidelines, assessing prior denials, and preparing clinical documentation for review. The ideal candidate must be familiar with Medicaid contract and Managed Care Legislation. Strong analytical skills and a thorough understanding of the appeals process are essential. Interested candidates should contact us at View phone number on click.appcast.io ASAP. #J-18808-Ljbffr Healthcare Support Staffing
- ...concept underlies their long term success in serving the needs of people with Medicare and/or Medicaid. Job Description Day to Day Responsibilities: The Clinical Appeals RN performs the clinical appeals in accordance with internal policy and procedures, as well as regulations...SuggestedContract workImmediate start
- ...Appeals & Grievance Specialist Schedule Monday – Friday Onsite Position Position Summary The Appeals &... ...maintaining compliance with Medicare, Medicaid, TRICARE, and other regulatory... ...accurate determinations. Coordinate with clinical, claims, customer service, provider...SuggestedWork at officeMonday to Friday
- ...Anesthesia, located in Addison, TX, is seeking a detail-oriented Appeals Specialist. The role is full-time and requires on-site presence during... ...coding. Familiarity with insurance policies, Medicare, and Medicaid regulations. Excellent written and verbal communication...SuggestedFull timeWork at office
- ...Appeals And Grievance Specialist II This position requires the ability to work independently researching and reviewing inquiries from members and... ...requirements established by the Centers for Medicare and Medicaid Services and TRICARE. Coordinates with pertinent...Suggested
- ...Medical University in Syracuse, NY is seeking a Commercial Review Specialist I to ensure patient care services are recorded and utilized... ..., and reimbursement contracts. The role emphasizes strong clinical knowledge and effective communication within care teams. Responsibilities...Suggested
- ...Appeals and Grievance Specialist II (Managed Care) – Irving, TX | 12-Week Contract Location: Irving, TX Job Type: 12-Week Contract Company: Sigma Inc. Schedule: Monday–Friday | 8-Hour Shifts Join Our Team as an Appeals and Grievance Specialist II! Sigma Inc....Contract workMonday to FridayShift work
- Oms Medical Billing in Addison, TX is hiring an Appeals Specialist. This full-time position requires on-site presence during regular business hours at our corporate office. The ideal candidate will review denied claims, prepare and submit appeal letters, and communicate...Full timeWork at office
- Upstate Medical University in Syracuse, NY seeks a UR-CR Specialist I to ensure accurate recording and utilization of patient care services... ...determine care level. You will act as a liaison for discharge appeals and social admissions, preparing regulatory notices for...
$22 per hour
Our client is hiring a Grievance and Appeals Specialist! In this role you would be responsible for analyzing and resolving verbal and written claims and authorization appeals from providers while pursuing resolution of formal grievances from members. As part of a collaborative...Hourly payPermanent employmentTemporary workWork experience placementShift work- ...Transform Care. We are seeking a RN Executive Director Specialist – Hospice to join our leadership team... ...performance improvement Drive clinical quality and ensure services meet... ...or healthcare Experience with Medicaid/Medicare regulations and reimbursement...Daily paidFull timePart timeLocal area
- ...Appointment Scheduling Specialist Heart & Vascular Specialist Clinic Full-Time, Days Bring your passion to Texas Health so we are Better + Together Work location: 6300 West Parker Road, MOB 2, Suite 322, Plano, TX 75093 Work hours: Full-time, 40 hours weekly, Monday thru...Full timeMonday to Friday
$45k - $55k
...Kids connects leading pediatric specialists with families to providebest-... ...requirements for Medicaid, managed Medicaid, commercial... ...teams, and patients. Review clinical documentation to ensure it meets... ...authorization denials or delays for appeal or peer-to-peer review. Maintain...Work at officeRemote work- OrthoMed Anesthesia in Addison, TX seeks a Healthcare Claims Denial Management Specialist to identify, analyze, and resolve denied or underpaid medical claims. Responsibilities include reviewing claims, communicating with insurance, and ensuring compliance with regulations...
$30 per hour
...national infusion company seeking experienced RN to join our team. This is a perfect... ...upbeat & fun team in a fast-paced and growing clinical environment. This is a great alternative... ...is hourly plus tips. Summary: An iV Specialists key role is to ensure clients are provided...Hourly payReliefShift work- ...an excellent academic record required; active Nursing license (RN, NP, or equivalent) and experience with healthcare provider strategy... ...are highly preferred5+ years of experience in a hospital/clinical setting, specifically within workforce management, staffing office...ApprenticeshipWork at officeEasy work
$72.8k - $130k
...rewarding opportunities for physicians, clinical staff and non-patient-facing roles. Join... ...Qualifications: ~ Active, unrestricted RN license ~5+ years of clinical nursing experience... ...supporting Commercial, Medicare, Medicaid, or SNP populations. ~ Experience with...Minimum wageFull timeWork experience placementLocal area- Byrne Dairy is searching for a Transfer Center Nurse Specialist in Syracuse, NY. This full-time role involves providing critical assessments and managing patient transfers into hospitals, ensuring compliance with regulations. Applicants must be licensed RNs, with either...Full timeNight shift
- A leading aesthetics clinic in Dallas, Texas is seeking a talented Aesthetics Registered Nurse to join their team. The RN will perform cosmetic injectable services, including neurotoxins and dermal fillers, while providing thorough education on procedures and aftercare...
- Crouse Health in Syracuse, NY is seeking a Clinical Abstraction RN for a temporary 3-6 month assignment to meticulously review medical charts, extract and structure clinical data, and perform quality assurance. The role requires an NY RN license, at least 2 years of healthcare...Temporary work
- Carter BloodCare in Dallas, TX is seeking an experienced RN to join our Clinical Apheresis team. The role involves performing cellular therapy collection procedures for CBC clients, with oversight of apheresis staff and coordination with physicians. Candidates must hold...ReliefFlexible hoursShift work
$29 - $38 per hour
Position Overview The Clinical Abstraction RN will meticulously review medical charts to extract, validate, and structure clinical data. This role is ideal for nurses familiar with clinical terminology, medical coding, or healthcare data. The position is temporary with...Hourly payTemporary work- The Clinical Abstraction RN at Crouse Medical Practice will diligently review medical charts to extract, validate, and structure clinical data in a fast-paced Syracuse setting. This temporary role (3-6 months) offers exposure to EPIC and healthcare data workflows, with...Temporary work
- ...Position: IV Wellness Specialist (Registered Nurse) Status: PRN, Part-Time... ...crave more balance. You want to use your clinical skills in a setting that gives you energy... ...environment. MINIMUM QUALIFICATIONS: ~ Active RN License ( REQUIRED ) ~2+ Years...Full timePart timeRelief
- ...staff to ensure that treatment plans are clinically appropriate and reimbursable, advocating... ...treatment authorization, concurrent review, and appeal processes. Submit required documentation... ...dependency setting. Licensure: Current RN, LCSW, or LPC license preferred. Skills...Full timePart timeWeekend work
- ...Job Summary: The CDI Specialist reviews inpatient medical records to ensure clinical documentation accurately reflects the severity... ...clinical justifications for appealed claims. Perform other duties as... ...related healthcare field required. RN, RHIA, RHIT, CCS, CCDS, CDIP, or...Work at office
$25 - $28 per hour
....We have an immediate need for a full-time Leasing + Marketing Specialist to join the team at one of United Group's professionally managed... ...market rates, advertising, signage, decor, amenities, and curb appeal to properly gauge the competitive landscape.Social Media:Uses...Hourly payFull timeWork experience placementLocal areaImmediate startMonday to Friday- ...mission! GENERAL PURPOSE: The Revenue Cycle Specialist is responsible for billing, collections,... ...payer timely correcting, rebilling, or appealing as necessary. Follows up with payers to... ...Understanding of the requirements of Medicaid, Medicare and Insurance billing is preferred...
$40k - $50k
Retention and Adherence LPN Specialist Syracuse Administrative, Secretarial & Clerical Allied Health Management & Professional Nursing... ...Inclusive Health Services and the Pediatric Infectious Disease Clinic's grant funded retention and adherence program. Position...Full timeWork at officeMonday to Friday- SUNY Upstate is seeking a highly motivated Retention and Adherence LPN Specialist to support patients in the Inclusive Health Services and Pediatric Infectious Disease Clinic grant-funded program. The role focuses on linkage to care, retention in medical services, and intensive...
- SUNY Upstate Medical University is seeking a Retention and Adherence LPN Specialist to support patients in the Inclusive Health Services and Pediatric Infectious Disease Clinic's grant-funded program. The role focuses on linkage to care, retention, and intensive case management...
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