RN-Led Clinical Denials & Appeals Strategist
UASI
UASI seeks an experienced Clinical Denials and Appeals Specialist to join our Denials Management team. You will review complex payer denials and develop high-quality appeal letters to maximize reimbursement for our healthcare clients. The ideal candidate will be a strong clinical reviewer and persuasive writer who analyzes medical records, identifies weaknesses in payer determinations, and crafts evidence-based appeals guided by clinical documentation and payer policies. #J-18808-Ljbffr UASI
$97.59k - $137.8k
...Partners International Inc (USPI) is seeking a Senior Specialist - Clinical Denials based in New York, NY. This role involves developing standards... ...denials. A Bachelor's degree in Nursing and an active RN license are required. The position offers a salary range of $9...Suggested- Altru Health System is looking for a Lead Denial Management Specialist to support daily operations and contribute to the development and implementation of policies and procedures. The role focuses on denial data, tracking denials by third-party payers and PPO networks,...SuggestedRemote work
$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...SuggestedPermanent employmentFull timeRemote workWork visa- Healthfirst is seeking an Appeals & Grievances Clinical Specialist responsible for receiving, investigating, and responding to member and provider appeals... ...regulatory site visits. Minimum qualification includes an RN license; preferred qualifications cover experience in...Suggested
$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...SuggestedRemote job- Alignment Health seeks a Clinical Appeals Nurse to review appeals for inpatient and outpatient services. The role requires applying clinical... ..., coding, and documentation, coordinate records, and prepare denial letters when needed. The position emphasizes HIPAA-compliant...
$81.1k - $116.48k
Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints... ...to the authorization of or delivery of clinical and non-clinical services. A&G works in collaboration... ...as assigned. Minimum Qualifications: RN, LPN OR Dental Hygienist Preferred...Remote jobContract workTemporary workWork experience placementLocal areaMonday to FridayShift work- ...teams to work at the highest levels possible. Job Summary The Clinical Nurse Risk Strategist translates complex medical and pharmacy claims data, along... ...audiences Education Active clinical license required (RN) Bachelor of Science in Nursing (BSN) strongly preferred...Immediate startFlexible hoursShift work
$95.3k - $158.8k
...helping healthcare and health education professionals improve clinical outcomes through evidence-based methods. Our generative AI Evaluation... ...are seeking an experienced Principal Clinical AI Evaluation Strategist (MD) to join our dynamic team. As a recognized authority in...Local areaWorldwide$132k - $174k
UCB is seeking a Rheumatology Clinical Account Specialist in Queens, NY to expand access and adoption of our immunology therapies. You will engage clinicians and care teams, manage a territory that includes southeastern Brooklyn, and develop strategic plans to drive product...- A global technology innovator is seeking a Clinical Education Consultant in New York, NY. This role focuses on strengthening customer relationships through strategic clinical engagement, providing education and support to ensure optimal use of solutions. Ideal candidates...Remote job
$95.3k - $158.8k
Elsevier is seeking a Principal Clinical AI Evaluation Strategist (MD) in Pennsylvania. In this role, you will set strategies and develop frameworks for evaluating generative AI in clinical solutions. Required qualifications include an MD with 10+ years of clinical experience...- Principal Clinical AI Evaluation Strategist (MD) This role is responsible for setting strategy and leading the evaluation of generative AI solutions for clinical and educational products, ensuring medical accuracy, reliability, and compliance within the healthcare domain...
- NYU Langone Hospitals in New York, NY is seeking a Sourcing Specialist-Clinical to provide strategic sourcing services for Clinical Product spend. The candidate will optimize vendor relationships, ensure alignment with departmental goals, and identify cost savings opportunities...Work at office
- Alignment Healthcare USA, LLC is looking for a full-time California Licensed Clinical Appeals Nurse to work in a fully remote environment. In this role, you will review and process appeals for inpatient and outpatient services, collaborate with medical directors, and ensure...Remote jobFull time
$59.83k - $89.75k
...Growing together. As a Governmental Audit Reviewer, you are the expert who ensures clinical documentation stands up to scrutiny. You take the lead in auditing, submitting, and appealing records for home health, hospice, LTACHs, and community-based services. When external...Minimum wageFull timeWork experience placementWork at officeLocal areaHome office- CareFirst, Inc. is seeking a full-time Clinical Medical Review Nurse to work remotely. In this... ...and institutional claims and provider appeals to determine eligibility for benefits. You... ...in Nursing or equivalent experience, RN licensure in VA, DC, or MD, and at least...Remote jobFull time
$77.91k - $116.86k
Santa Barbara Cottage Hospital seeks a Clinical Appeals Nurse responsible for reviewing appeals for inpatient and outpatient services. This role... ...' clinical nursing experience and a valid California LVN or RN license. The job offers a competitive salary range of $77,905....- 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
- Back Appeal Analyst RN | Remote | Contract Business & Care Management Contract Jul 7, 2026 Appeals Nurse | 2 years’ experience | Remote... ...an active Compact Licensure -NJ, NY, DE, CT, PA 2 Years of Clinical Experience Proficiency in the use of personal computers and...Remote jobWeekly payContract workLocal areaImmediate startMonday to Friday
- ...Shield of Arizona is seeking a skilled professional for a clinical role addressing provider appeals and grievances. This position demands expertise in... ...ideal candidate will possess a relevant degree, an active RN license, and several years of experience in healthcare,...Remote job
$2,080 per week
...Ventura MedStaff is seeking an experienced Outpatient Clinic Registered Nurse for an exciting Travel Nursing job in Geneva, NY. Shift: 5x8 hr days Start Date: 08/03/2026 Duration: 27 weeks Pay: $2080 / Week About Ventura MedStaff: Founded in 2018 and located in...Shift work- ...get the right care at the right time, staff members burn out, and clinics lose billions in revenue. This isn't a failure of care - it's a... ..., Ophelia), and our CTO is an ex-Amazon Alexa engineer who led AI/ML teams at Salesforce. Outsized early impact: You'll be joining...Casual workWork at officeFlexible hours
$122.63k - $255.63k
Yahoo Holdings Inc. seeks a Vertical Strategist (Auto & Travel) in New York to create tailored advertising solutions across its iconic brands. Ideal candidates will have 5-7 years in digital media and advertising, particularly in the Auto and Travel sectors, and possess...- EMC is seeking a RN-led Clinical Services leader to oversee daily operations across nurse case management, pharmacy, and claim review. The role drives performance, integrates clinical services with claims processes, and partners with claims leadership to improve outcomes...Remote job
$34 - $35 per hour
Utilization Management - Clinical Nurse - Work from Home! Utilization... ...Ensure timely processing of all denial determinations according to... ...conversations and communicating appeal processes Distributed denial... ...reliability reviews Qualifications RN license in an eNLC (Enhanced...Full timeWork at officeRemote workWork from homeNight shift- ...Registered Nurse (RN) Atria is a membership-based preventive health care practice delivering... ...diseases. Each member's care is led by a dedicated Chief Medical Officer who collaborates... ...practice. This role serves as a key clinical partner to the Manager on Duty (MOD),...
$1,944 per month
...York Eye and Ear Infirmary of Mount Sinai Job Type Travel Offering Nursing Profession RN Specialty Clinic Job ID 26732617 Job Title RN - Clinic Weekly Pay $1944.0 Shift Details...Weekly payExtra incomeShift workNight shift$57.39 - $75.88 per hour
...Dart Solutions is looking for a Registered Nurse (RN) for their Methadone Clinic in Brooklyn, NY. The position involves assessing patients' health statuses, formulating care plans, and collaborating with the care team to ensure optimal patient care. Qualified candidates...Hourly pay$35.47 - $58.53 per hour
## CLINIC RNApplyremote type: Onsitelocations: Samaritan Cardiologytime type: Full timeposted on: Posted Todayjob requisition id: R2888Location... ...to geriatric, to whom health care is provided.* Current NY RN license.* Certified CPR.Samaritan is an Affirmative Action/Equal...Shift workDay shift
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