Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote RN Clinical Appeals Lead

Ohio State University

Brooklyn, NY
  • Remote job

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 will have extensive experience in nursing, claim denial processes, and effective communication skills. The role includes monitoring denial trends and supporting departmental goals through collaboration and quality assurance. #J-18808-Ljbffr Ohio State University

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote RN Clinical Appeals Lead in Brooklyn, NY vacancy
  • The Ohio State 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... 
    Suggested

    The Ohio State University Wexner Medical Center

    Brooklyn, NY
    1 day ago
  • 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...  ...This role offers the opportunity to work remotely and is ideal for a Registered Nurse with leadership... 
    Remote job

    Ohio State University

    New York, NY
    1 day ago
  • $102.95k - $154.42k

     ...Nurse Appeals Lead- RN Locations: Indianapolis, IN, Grand Prairie, TX; Woodland Hills, CA and Costa Mesa, CA Virtual : This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and... 
    Suggested
    Full time
    Temporary work
    Work experience placement
    Work at office
    Local area
    1 day per week

    Elevance Health

    Grand Prairie, TX
    4 days ago
  •  ...Job Summary Provides clinical leadership and support, patient...  ...companies, other medical practices, remote patient monitoring program,...  ...techniques/practices of tasks. # Leads group discussions, problem...  ...Previous clinical experience as an RN in an ambulatory care setting... 
    Remote work
    Work at office
    Weekend work
    Afternoon shift

    Contentnea Health

    Snow Hill, NC
    24 days ago
  • MVP Health Care is seeking a Clinical Appeals RN to ensure fair and timely review of healthcare service denials. This role involves analyzing medical records and clinical documentation and collaborating with medical directors to decide on appeals. The ideal candidate will... 
    Remote job

    MVP Health Care

    Schenectady, NY
    1 day ago
  • $88.85k

     ...Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: Full...  ...work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift... 
    Remote work
    Full time
    Shift work
    Weekend work

    LOS Angeles Care Health Plan

    Los Angeles, CA
    1 day ago
  •  ...medical documentation while working remotely. This role involves managing appeals and validating claims to ensure medical...  ...will have at least 2 years of clinical nursing experience, including utilization review, and a valid RN license in Florida or Kentucky. Strong... 
    Remote job
    Full time

    Molina Healthcare, Inc.

    New York, NY
    3 days ago
  • Curana Health is seeking a Quality Registered Nurse (RN) to oversee clinical quality and compliance across multiple clinics in the United States...  ...skills in quality improvement. This role is primarily remote or hybrid with occasional travel to clinics as necessary.... 
    Remote job

    Curana Health

    New York, NY
    2 days ago
  • Curana Health, Inc. is looking for a Quality Registered Nurse (RN) to oversee clinical quality and compliance across multiple primary care clinics...  ...and regulatory standards. The position is primarily remote or hybrid, involving travel to clinic sites. You'll collaborate... 
    Remote job

    Curana Health, Inc.

    New York, NY
    14 hours ago
  • $80k - $90k

     ...Machinify organization. Machinify is a leading healthcare intelligence company with...  ...Range: $80-90k The Medical Review Clinical Appeals Auditor (RN) is responsible for conducting Appeals...  ...the ability to work independently in remote setting with minimum supervision and... 
    Remote work
    For contractors
    Immediate start
    Work from home
    Home office
    Flexible hours
    Shift work

    The Rawlings Group

    Plantation, FL
    23 hours ago
  • $52 per hour

     ...Hiring for RN - Appeals (Remote Role) in Somerville, MA Shift: Days 5x8 (08:00 - 17:00) Duration: 13 Weeks (Temp to Perm) Pay Rate: $52/hr on W2 ($2,080/WK) OT: $78/hr after 40hrs weekly Requirements: ~ MA RN License, BLS (AHA) ~100% remote ~ Looking for... 
    Remote job
    Permanent employment
    Temporary work
    Shift work

    Pacer Group

    Somerville, MA
    1 day ago
  • $28.94 - $51.63 per hour

    Wisconsin Psychiatric Association Inc is seeking a Clinical Appeals RN to manage appeals and grievances effectively. This role requires a registered...  ..., and ensure compliance with all regulations while working remotely from anywhere in the U.S. Attractive benefits and... 
    Remote job
    Hourly pay
    Work at office

    Wisconsin Psychiatric Association Inc

    Cypress, CA
    1 day ago
  • 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... 
    Remote work

    Remote Jobs

    New York, NY
    4 days ago
  • The Elevance Health Companies, Inc. is seeking a Nurse Appeals RN-Quality of Care based in Metairie, Louisiana. The role involves investigating medical necessity appeals and reviewing member grievances to ensure timely resolutions. Applicants must have a current RN license... 
    Remote job
    Full time

    The Elevance Health Companies, Inc.

    Metairie, LA
    4 days ago
  • Blue Shield of CA is seeking a Medicare Appeals RN Senior in Los Angeles, CA. This role involves reviewing member appeals and grievances,...  ...experience. The position allows for hybrid virtual work, balancing remote responsibilities with in-office requirements as needed for... 
    Remote work
    Work at office

    Blue Shield of CA

    Los Angeles, CA
    2 days ago
  • $54.1k - $155.54k

    4062 Aetna Resources, LLC is seeking a Clinical Team Lead to provide leadership and clinical support for a team responsible for Utilization Management Outpatient Appeals. This full-time remote position requires strong nursing experience, effective communication, and problem... 
    Remote job
    Full time

    4062 Aetna Resources, LLC

    Hartford, CT
    23 hours ago
  •  ...Nurse Appeals RN-Quality of Care Nurse Appeals RN-Quality of Care Must reside in the state of Louisiana. Locations: Metairie,...  ...expert for grievances/quality of care issues and is a resource for clinical and non-clinical team members in expediting the resolution of... 
    Remote work
    Full time
    Work at office

    Elevance Health

    United States
    23 hours ago
  • $248.5k - $373k

    UnitedHealth Group is seeking an Appeals and Grievances Medical Director responsible for reviewing and adjudicating...  ...role requires an MD or DO with experience in clinical practice and Quality Management. This position offers remote work flexibility, allowing for a dynamic work... 
    Remote job

    UnitedHealth Group

    Cypress, CA
    4 days ago
  • $57.28 - $88.92 per hour

     ...Management Recovery Advocate in Torrance, CA, responsible for managing clinically-based appeals and supporting patient advocacy for reimbursement. The role requires an Associate's Degree in Nursing, California RN License, and relevant experience in acute care settings. Join a... 
    Remote job
    Hourly pay

    Providence Health Plan Group

    Torrance, CA
    4 days ago
  •  ...Appeals Processor III - RN ~ salary ~ Unavailable ~ Hours per week ~40 ~ Shifts ~5/8's...  ...III) to join our dedicated team in a remote capacity. The Appeals Processor III (...  ...Experience reviewing medical documentation (clinical roles may require RN)... 
    Remote work
    Contract work
    For contractors
    For subcontractor
    Shift work

    Ghost RX

    Orlando, FL
    23 hours ago
  • 260 CGS Administrators, LLC is seeking a RN Appeals Analyst to join their team. This fully remote role involves conducting thorough clinical reviews to determine medical necessity guidelines for appeals. Ideal candidates will have a nursing degree and relevant clinical... 
    Remote job
    Work at office

    260 CGS Administrators, LLC

    Nashville, TN
    2 days ago
  • BlueCross BlueShield of South Carolina is seeking a RN Appeals Analyst to join their team in a fully remote role. The analyst will handle complex appeal...  ...full-time position requires an Associate's degree, clinical experience, and a valid RN license. Key responsibilities... 
    Remote job
    Full time

    Remote Jobs

    Nashville, TN
    2 days ago
  • L.A. Care Health Plan is hiring an Appeals and Grievances Nurse Specialist RN II in Los Angeles. This role involves assisting members with healthcare access issues and resolving complaints in compliance with regulatory standards. The ideal candidate must have an Associate... 
    Remote job

    L.A. Care Health Plan

    Los Angeles, CA
    3 days ago
  • $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

    Healthfirst

    New York, NY
    2 days ago
  •  ...company located in New York is looking for a Clinical Auditor to perform clinical reviews and...  ...guidelines. This role requires an active RN license and the ability to analyze claims...  ...documentation and reporting within the appeals process, contributing to continuous improvement... 
    Remote job

    Performant Corp

    Florida, NY
    1 day ago
  • Phamily is seeking a Clinical Care Lead RN to work in a hybrid capacity, supporting patients through digital communication tools. This role involves managing a digital patient panel, developing personalized care plans, and leading a clinical team. Ideal candidates will... 
    Remote job

    Phamily

    Atlanta, GA
    23 hours ago
  •  ...Appeal Specialist II - RN The Appeal Specialist II - RN reviews, analyzes, and resolves insurance denials to ensure accurate reimbursement and...  ...Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 3... 
    Remote job
    Work at office

    Community Health Systems

    Franklin, TN
    23 hours ago
  • $68.97k - $113.31k

     ...The Senior RN Clinical Consultant will work in partnership with Clinical and Vocational Leaders...  ...in all lines of business (STD/LTD/Appeals) and products, action planning management...  ...leadership as needed Location This is a remote position with occasional travel as... 
    Remote work
    Full time
    Visa sponsorship
    Work visa
    Flexible hours

    Guardian Life

    Plano, TX
    5 days ago
  • $29 - $52 per hour

     ...have the flexibility to work remotely as you take on some tough challenges...  ...initial assessment review of appeals, medical records, and CMS/...  ...work independently Utilize Clinical nursing judgment assessment and...  ..., valid, and unrestricted RN licensure in your state of residence... 
    Remote job
    Hourly pay
    Minimum wage
    Full time
    Work experience placement
    Work at office
    Local area
    Monday to Friday

    UnitedHealth Group

    Cypress, CA
    3 days ago
  • $35 - $62.5 per hour

     ...Qualifications Associate’s Degree in a related clinical field from an accredited college. Current, unrestricted California RN license. 3+ years of broad‑based clinical...  ...comply with all minimum wage laws as applicable. Remote Work Policy Employees working remotely will... 
    Remote work
    Hourly pay
    Minimum wage
    Full time
    Work experience placement
    Local area
    Shift work

    Council of State and Territorial Epidemiologists

    Los Angeles, CA
    1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote RN Clinical Appeals Lead. Be the first to apply!