Remote RN Clinical Appeals Lead
Ohio State University
- 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
- 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 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
$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...SuggestedFull timeTemporary workWork experience placementWork at officeLocal area1 day per week- ...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 workWork at officeWeekend workAfternoon shift
- 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
$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 workFull timeShift workWeekend work- ...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 jobFull time
- 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, 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
$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 workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work$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 jobPermanent employmentTemporary workShift work$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 jobHourly payWork at office- 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
- 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 jobFull time
- 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 workWork at office
$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 jobFull time- ...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 workFull timeWork at office
$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$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 jobHourly pay- ...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 workContract workFor contractorsFor subcontractorShift work
- 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 jobWork at office
- 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 jobFull time
- 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
$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- ...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
- 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
- ...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 jobWork at office
$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 workFull timeVisa sponsorshipWork visaFlexible hours$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 jobHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaMonday to Friday$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 workHourly payMinimum wageFull timeWork experience placementLocal areaShift work
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