Remote Appeals RN - Clinical Grievances & Decisions
Palo Verde Community College District
- Remote job
UnitedHealthcare is seeking a Clinical Appeals RN to provide expertise in appeals and grievances, serving as a Clinical Interface Liaison with facilities, providers, and carriers. The role allows remote work from anywhere in the U.S., with a schedule of M-F 8:00-4:30 and alternating Saturdays, plus potential overtime. Responsibilities include reviewing medical records, determining eligibility, and documenting outcomes. #J-18808-Ljbffr Palo Verde Community College District
$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... ..., and reference internal policies. Make decisions, document cases, and manage work within...Remote jobFull timeMonday to FridayShift work$81.1k - $116.48k
Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst... ...of or delivery of clinical and non-clinical... ...This position is 100% Remote. We are hiring for the... ...and procedures to frame decisions Interpret regulations... ...Minimum Qualifications: RN, LPN OR Dental...Remote jobContract workTemporary workWork experience placementLocal areaMonday to FridayShift work- ...individuals make better health decisions. At AZ Blue, we have... ...as hybrid, onsite or remote. While the majority of... ...for utilizing clinical acumen and managed care... ...for member and provider appeals, grievances, reconsiderations and... ...a Registered Nurse (RN) Required Certifications...Remote jobContract workWork experience placement1 day per week
- Healthfirst is seeking an A&G Clinical Specialist to lead the development and resolution of clinical cases for member and provider appeals, ensuring compliance with applicable laws and internal policies. The role can be remote or on-site at the NYC or Lake Mary locations...Remote work
$71.59k - $116.48k
...prominent healthcare organization is seeking an A&G Clinical Specialist to manage health member complaints and appeals. This fully remote position requires expertise in clinical case... .... The ideal candidate should be an RN, LPN or Dental Hygienist with experience in appeals...Remote job- 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
- UnitedHealthcare is seeking a Clinical Appeals RN to provide expertise in clinical appeals and grievances, analyzing, reviewing, and evaluating appeals and grievances,... ...benefits. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some...Remote job
- ...global organization delivering care supported by technology to help millions live healthier lives. The Clinical Appeals RN defends MassHealth prior authorization decisions and conducts pre-service reviews, working with managers and peers. Based in Massachusetts with...Remote job
- UnitedHealth Group is seeking a Clinical Appeals RN to analyze appeals and grievances, acting as a clinical interface liaison with facilities, providers, and carriers. Remote work is offered across the U.S. with a M-F schedule and alternating Saturdays. Responsibilities...Remote job
- UnitedHealth Group is seeking a Clinical Appeals RN to attend MassHealth appeal hearings, defend prior authorization decisions, and perform pre-service clinical coverage reviews.... ...years in Managed Care or clinical settings. Remote work within Massachusetts is available...Remote job
$28.94 - $51.83 per hour
...Clinical Appeals RN Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives... ...appeal hearings, defending MassHealth prior authorization decisions, and performing pre-service/prior authorization clinical coverage...Remote jobHourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal area- Optum, a part of UnitedHealth Group, seeks a Clinical Appeals RN to attend MassHealth appeal hearings, defend prior authorization decisions, and conduct clinical coverage reviews for the MA program. This role supports the MA MLTSS program and requires in-state nursing...Remote job
- UnitedHealth Group in Massachusetts is seeking a Clinical Appeals RN to attend appeal hearings and defend MassHealth prior authorization decisions. The role supports pre-service/prior authorization reviews and requires MA licensure and clinical experience. The position...Remote job
- Medica, a nonprofit health plan, is seeking a remote Appeals & Grievances Clinical Specialist III to review and resolve appeals and grievances with clinical... ...and clinical staff. This position requires an active RN license and 5+ years of clinical experience, preferably...Remote job
- UnitedHealth Group is seeking an experienced Clinical Appeals RN to analyze and resolve appeals and grievances. This remote role supports facilities, providers, and members by applying clinical criteria and coordinating with Medical Directors. Responsibilities include...Remote job
$28.94 - $51.63 per hour
...Caring. Connecting. Growing together. The Clinical Appeals RN is responsible for providing expertise in clinical appeals and grievances (analyzing, reviewing, and evaluating... ...). You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take...Remote jobHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaWeekday work$70k - $80k
...Piper Companies is seeking a Remote Clinical Appeals Analyst to provide clinical expertise in reviewing and resolving complex member and provider... ...must hold an active North Carolina licensure as an RN, LPN, PT, or OT and have significant clinical experience. The...Remote workFull timeContract workMonday to Friday- Working Nurse in Los Angeles is seeking a Supervisory RN for Appeals and Grievances Clinical Operations. This full-time role oversees day-to-day clinical operations, staffing, and performance evaluations within the A&G department. You will mentor staff, ensure compliance...Full time
$102.18k
RN Job Supervisor, Appeals and Grievances Clinical Operations RN Shift Full Time Pay Range $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Job ID 13204 Location Los Angeles, 90017 Apply at Website Email Recruiter Job Description The Supervisor of...Full timeShift work- Appeals AND Grievance Registered Nurse Ii‑Clinical Appeals‑Tlra job at Christus Health. Houston, TX. DescriptionSummary: Responsible for the management and communication... ...all possible levels of the appeal process. The RN Clinical Appeals Nurse will actively manage, maintain...Full timeFor contractors
- ...UnitedHealthcare is hiring a Medical Director for Appeals and Grievances, responsible for clinical review and adjudication across multiple health plans. The role supports remote work from anywhere in the U.S. and requires collaboration with regional and plan medical directors...Remote job
- Registered Nurse (RN) Clinical Denials and Appeals United States Job Description Inova 8095 - Fairfax East is looking for a dedicated Registered Nurse... ...Appeals to join the team. This role will be Full-Time Remote, Monday-Friday (8-Hours per Day); Start Time to be between...Remote workFull timeMonday to FridayFlexible hours
- Inova Health System is seeking a Registered Nurse (RN) for Clinical Denials and Appeals. This full-time remote role supports denials and appeals across facilities, with start times between 7:30 AM-9:00 AM ET. The role requires a bachelor’s or associate degree with RN license...Remote jobFull time
- Inova Health System is seeking a dedicated Registered Nurse (RN) Clinical Denials and Appeals to join the team as a Full-Time Remote role. The position supports review of denied claims, development and submission of timely appeals, and collaboration across UR, Coding, Billing...Remote jobFull time
- ...Cottage Hospital is seeking a PRN Clinical Review Specialist to provide remote clinical review support. You will evaluate... .... The role requires an active RN license (compact preferred), 3-5... ...and 2+ years in Utilization Review/Appeals. Strong documentation and Epic EMR...Remote jobRelief
$248.5k - $373k
...,000.00Job Area: Medical & Clinical OperationsCompany: UnitedHealth... ...the flexibility to work remotely * from anywhere within the... ...Primary Responsibilities:The Appeals and Grievances Medical Director is... ...directors regarding appeals decision rationales, and benefit interpretations...Remote workMinimum wageWork experience placementLocal areaWork from home$91.7k - $163.7k
...00/yearJob Area: Medical & Clinical OperationsCompany: UnitedHealth... ...the flexibility to work remotely * from anywhere within the... ...with and supervision by an Appeals and Grievances Medical Director, the Physician... ...regarding appeals decision rationales and benefit interpretationsActively...Remote workMinimum wageFull timeWork experience placementLocal areaMonday to Friday- ...to do meaningful work, build a career, and feel proud serving your community—you belong at St. Joe’s. Job Summary The Clinical Denial Appeals Coordinator supports the Revenue Cycle by assessing and utilizing clinical and financial information to obtain optimal...Remote workWork at office
- Job Description Job Description - Clinical Nurse - Emergency Department - Clinical Decision Unit (250003ZO) Description Under general supervision, following established... ...Circle, Tampa 33601 Job Details Eligible for Remote Work: On Site Job Type: Nursing (LPNs, RNs) #J-18...Remote work
$80k
...documentation for any patient clinical condition or procedure... ...and writes denial appeal letters.Collaborates... ...Minimum Education:Current RN LicensureCertifications... ...Top Workplace for Remote Work 2024Great Place to... ...transparency. Compensation decisions consider many job-related...Remote workLocal area
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