RN Clinical Denials & Appeals Specialist
Remote Jobs
Remote Jobs is seeking an experienced clinical appeals specialist to join their team. The role requires a Registered Nurse (RN) with at least one year in ICU or demonstrated proficiency in appeals writing for hospital services. You will review denials, conduct research, and collaborate with departments for patient information in a fully remote environment. Candidates should possess strong problem-solving skills, proficiency in Microsoft tools, and extensive knowledge of medical coding and billing. The position offers a competitive pay range and an inclusive work culture. #J-18808-Ljbffr Remote Jobs
- Capital Health is seeking a Clinical Denials Utilization Review RN in New Jersey to manage utilization reviews related to inpatient care. The role involves overseeing denial and appeal processes, ensuring compliance with CMS guidelines, and requires a minimum of five years...Suggested
- ...consulting firm is expanding its team by hiring a Clinical Appeals Review Nurse. This role involves completing clinical denial reviews, performing various audit services, and... .... Required qualifications include an RN certification, experience with DRG denials, and...Suggested
- ...University Wexner Medical Center is seeking a Clinical Financial Case Manager, RN - Escalation Lead to provide advanced clinical appeal services. This role involves reviewing and escalating complex patient account denials while monitoring payer denial trends and assisting...Suggested
- A healthcare provider in Georgia is seeking a Denial Specialist responsible for coordinating appeals and collection efforts for denied services. Candidates should have 2-3 years of medical background and 1-2 years of experience in insurance and denial management. The role...Suggested
- ## Clinical Denials Utilization Review RN - FT - Day - Utilization Resource Management Pennington NJApplylocations: RMCtime type: Full timeposted on:... ...Health related to third party reimbursement, denials, appeals and clinical audits for inpatient cases. Ensures responsibility...SuggestedFull timeTemporary workPart timeFlexible hours
$30 per hour
...New Jersey. This role offers a perfect alternative to traditional shifts, allowing nurses to use their IV skills effectively in a clinical setting. Candidates should have a minimum of 2 years of experience, excellent IV skills, and a desire to help clients improve their...Hourly payReliefShift work- Ohio State University seeks a Clinical Financial Case Manager RN - Escalation Lead to provide advanced clinical appeal services for complex patient account denials. This remote position requires a Bachelor's Degree in Nursing and a current RN license. The ideal candidate...Remote job
- Knowtion Health is hiring for a remote position that involves analyzing denied claims, resolving account denials, and maintaining records of claims activities. Ideal candidates will have a minimum of 6 months of experience in hospital or healthcare billing settings, expertise...Remote job
- TELCOR Inc is seeking a detail-oriented Remote Billing Specialist. This full-time position manages operational revenue cycle tasks, focusing on payer denials, unpaid balances, and trend identification to enhance customer outcomes. The ideal candidate will have at least...Remote jobFull time
- The Ohio State University is looking for a Clinical Financial Case Manager - RN - Escalation Lead to provide advanced clinical appeal services, manage complex patient account denials, and assist in developing denial prevention strategies. This role offers the opportunity...Remote job
$36 - $40 per hour
...fulfillment in your coding career. If you are an Appeals and Denials Nurse looking for a new opportunity to... ...and health benefits Our requirements: RN or FMG: CDIP, CCDS, CCS and/or ICD-10... ..., NY $85,000.00-$95,000.00 1 month ago Clinical Review Nurse - Prior Authorization...Permanent employmentFull timeRemote workWork visa- Shriners Children's is seeking a Denials Management Appeals Nurse (Anesthesia) to manage medical denials by reviewing clinical documentation and filing compliant appeals. The role... ...experience, 3 years in Anesthesia, and a current RN license in their state. Knowledge of Third...
- Knowtion Health is seeking an Appeals Nurse to oversee the review and appeal of claims related to clinical denials from Medicare, Medicaid, and other payers. The ideal candidate will have a valid RN license, experience in an acute care setting, and familiarity with utilization...Remote job
$13.41 - $29.06 per hour
...standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). Essential Job Duties Enters denials and requests for appeals into information system and prepares documentation for further review. Researches claims issues utilizing systems and...Hourly payWork experience placementWork at office$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... ...independently. The ideal candidate should be an RN, LPN or Dental Hygienist with experience in appeals...Remote job$23 - $31 per hour
Remote Physician Denials Specialist - 248391 Get AI-powered advice on this job and more exclusive... ....00/hr Professional Billing Denials & Appeals Analyst Full-Time | Remote (with location... ...clear, accurate, and persuasive non-clinical appeal letters. Submit payer disputes...Remote jobHourly payFull timeWeekday work- ## Authorization Integrity Specialist - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJApplylocations: 3131... ...corrections with Central Scheduling, clinical departments, physician offices,... ...or equivalent. Registered Nurse (RN) license preferred. Certification...Full timeTemporary workPart timeWork at officeFlexible hours
- ...analysis of denied claims to determine the underlying reasons for denial and execute all necessary follow‑up actions. Communicate with... ...and up‑to‑date records of all claim activities, encompassing appeals, follow‑ups, and resolutions in Artiva and client systems as appropriate...Temporary workRemote work
$20 - $23 per hour
...insurance companies for timely payments. Candidates should have a high school diploma or GED, along with experience in healthcare denials and appeals. We offer a comprehensive benefits package and the position includes a pay range of $20.00 to $23.00 per hour. #J-18808-...Hourly pay$10 per hour
...healthcare solutions provider is seeking a Certified Professional Coder (CPC) to manage denial issues and ensure accurate medical billing. The ideal candidate will analyze denials, manage appeals, and ensure compliance with coding guidelines. Applicants should have a CPC...Remote jobFull time$28.85 - $35 per hour
Scion Staffing has been engaged to conduct a search for a Denials & Revenue Recovery Specialist for a fast-growing healthcare revenue recovery... ...workflows. You will manage assigned denial queues, submit appeals, and follow claims through to final resolution while maintaining...Remote jobHourly payTemporary workInterim roleFlexible hours- Mount Sinai Medical Center seeks a Denials Coordinator to manage and resolve denied insurance claims. This position involves analyzing denial trends, coordinating appeals, collaborating with various departments to prevent future denials, and maintaining compliance with...
$21 - $31.95 per hour
...seeking a Revenue Cycle AR and Follow-Up Specialist to manage the accounts receivable... ...ensuring timely payments, resolving claim denials, and maintaining precise financial records... ...along with comprehensive benefits. #J-18808-Ljbffr Clinical Health Network For TransformationHourly pay$48.6k - $83.16k
...Position Responsible for processing expedited appeals: those that are complex in nature,... ...times of the Expedited Appeal unit, the Specialists are required to work weekends and holidays... ...for authorized representative or needed clinical information. Conduct thorough...Remote jobHourly payContract workWeekend work$58.5k - $69.97k
Position Summary We have an exciting opportunity to join our team as a Data Analyst, Financial Data Governance and Quality. The successful candidate reports to the Assistant Manager, Financial Data Governance and Quality and will maintain and analyze data within PeopleSoft...Work experience placement- ...Ohio State University Wexner Medical Center seeks a Clinical Financial Case Manager - RN to implement and support their mission and policies... ...role involves securing complex pre-authorizations, appealing clinical denials, and requiring a keen understanding of clinical...
- ...individuals can redefine their narratives and become their best selves. Summary Reporting to the Program Coordinator, the Peer Specialist for the Clinical Rapid Response Team (CRRT) will play a critical role in providing immediate support and assistance to individuals...Work at officeImmediate startFlexible hoursAfternoon shift
- ...Psychiatric Mental Health Nurse Practitioner (PMHNP) for a hybrid position in Westchester, NY. This role allows for a blend of on-site clinical care and telehealth services, emphasizing variety, autonomy, and growth. The ideal candidate will have a strong foundation in...
$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...Hourly payReliefShift work$23.1 per hour
...are hiring for our Full-Time Assistant Behavior Intervention Specialist position at our Avenue Z IRA. Job Description The ABIS works... ...three. The ABIS position blends together the DSP role and the clinical leadership role. Clinical leadership under the supervision of...Full timeWork from homeFlexible hoursWeekend work
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