Remote Appeals Clinician I — RN
Cambia Health Solutions
- Remote job
Cambia Health Solutions is looking for an Appeals Clinician I to join their Clinical Services team. This role focuses on ensuring compliance with medical policy through clinical appeal reviews. Ideal candidates will have a Bachelor's Degree in Nursing and essential clinical experience. The position offers work-from-home options in Oregon, Washington, Idaho, or Utah. Cambia provides a competitive salary and benefits, including medical coverage, paid time off, and a retirement plan. #J-18808-Ljbffr Cambia Health Solutions
- ...Cambia Health Solutions seeks an Appeals Clinician I to leverage clinical expertise in resolving appeals while enhancing patient advocacy. Located... ...hold a Bachelor's Degree in Nursing and possess a current RN license, alongside excellent skills in claim reviews and healthcare...Remote workWork from home
- ...Cambia Health Solutions seeks an Appeals Clinician I to handle clinical appeal processes while working from home within specific states. Candidates must have a Bachelor's Degree in Nursing and an active RN license in Oregon, Washington, Idaho, or Utah. This position involves...Remote workWork from home
$76.5k - $103.5k
...Cambia Health Solutions is looking for an Appeals Clinician I, focusing on resolving member appeals with your clinical expertise. You will ensure... ...have a Bachelor's Degree in Nursing along with an active RN license. The role offers a competitive salary, with the expected...Remote workWork from homeFlexible hours- ...Cambia Health Solutions is looking for an Appeals Clinician I to join our team in Minot, ND. In this role,... ...possess a Bachelor's Degree in Nursing, a valid RN license, and relevant clinical experience. The role offers remote work options and a competitive salary scheme...Remote work
- ...Cambia Health Solutions is seeking an Appeals Clinician I to leverage clinical expertise in assessing... ...compliance with medical policies. This remote position is open to candidates residing... ...Bachelor's Degree in Nursing, an active RN license, and at least 3 years of...Remote work
- Cambia Health Solutions is looking for an Appeals Clinician I to work remotely from Oregon, Washington, Idaho, or Utah. This critical role will utilize... ...candidate has a Bachelor’s Degree in Nursing, an active RN license, and at least three years of relevant clinical experience...Remote job
$76.5k - $103.5k
Cambia Health Solutions is seeking an Appeals Clinician I to utilize clinical expertise in resolving member and provider appeals. This role is... ...members and requires a Bachelor's Degree in Nursing, an active RN license, and relevant clinical experience. The expected salary...Remote job$76.5k - $103.5k
...Appeals Clinician I Work from home within Oregon, Washington, Idaho or Utah Build a career... ...outcomes that matter most to them? Are you an RN who finds yourself asking 'why' when a... ...appeals staff on clinical cases. #LI-Remote Pay ranges vary based on the...Remote workFull timeImmediate startWork from homeFlexible hours- ...and talented Registered Nurse Clinician to join our busy, fast paced... ...closely with Prior Authorization on appeals for surgical cases... ...experience preferred Active RN License Certification in... ...Minneapolis with rotation to remote clinics as business dictates...Remote workFull timeTemporary workWork at officeMonday to FridayFlexible hours
- ...CorroHealth Inc is seeking a Manager of Clinician Appeals to provide strategic oversight in clinical... ...while leading high-performing teams remotely. This individual will manage the clinical... ...environment. The ideal candidate will possess an RN, MD, or DO license with a minimum of 8...Remote work
$29 - $52 per hour
...UnitedHealth Group is seeking a Remote Registered Nurse (RN) in California to handle appeals and medical record reviews. The ideal candidate should possess a current RN license and have at least 2 years of clinical experience. This role also requires familiarity with...Remote workHourly pay$68.97k - $113.31k
...The Senior RN Clinical Consultant will work in partnership with... ...lines of business (STD/LTD/Appeals) and products, action planning... ...ideas for improvement Support Clinicians in developing efficient desk &... ...Location This is a remote position with occasional travel...Remote workFull timeVisa sponsorshipWork visaFlexible hours- ...Crains Cleveland is seeking a Clinical Appeals RN responsible for attending appeal hearings and defending MassHealth prior authorization decisions. The position offers the opportunity to telecommute and requires candidates to reside in Massachusetts. Ideal candidates...Remote work
- ...Elevance Health is seeking a Medical Management Clinician Senior to manage complex cases and oversee clinical information assessments. The... ...clinical or utilization review experience and active LPN/LVN or RN licensure. This role can be performed virtually, allowing for flexibility...Remote work
$95k - $110k
...DRG Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most... ...guidelines; successfully completes required CEUs to maintain RN license and/or coding certification. Responsible for attending...Remote workFull timeWork from homeRelocation packageFlexible hours$90k - $99k
...healthcare solutions provider seeks a DRG Nurse Reviewer Appeals and Hearings to coordinate appeal duties and engage... ...virtual and on-site. Candidates must have an active RN license and coding certification. This remote role offers flexibility and opportunities for career...Remote workFlexible hours- The University of Minnesota School of Nursing is hiring a Clinical Appeals RN to manage appeal hearings and defend MassHealth's prior authorization decisions. This role requires individuals who reside in Massachusetts, with an opportunity to telecommute. Key qualifications...Remote jobFlexible hours
- 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 job
- Stryker Corporation is looking for a Clinical Appeals RN in Massachusetts to represent MassHealth at appeal hearings and defend prior authorization decisions. The ideal candidate will have clinical experience, an RN license, and strong communication and time management...Remote job
- ...health solutions company is looking for an Appeals Nurse to examine medical records and... ...candidate will have a nursing degree, active RN license, and experience in a clinical setting. Benefits include competitive pay, remote work options, and health insurance starting...Remote work
$88.85k
...Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position... ...work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical...Remote workFull timeShift workWeekend work$29 - $52 per hour
UnitedHealth Group is seeking a Clinical RN to conduct appeals assessment and care reviews. This role offers the flexibility to work remotely, adhering to Eastern or Central Standard Time. Candidates must have valid RN licensure and at least 2 years of clinical experience...Remote jobHourly pay- ...—A health solutions company is seeking an Appeals Nurse to examine medical records and claims... ...possess a nursing degree and an active RN license, with at least one year of clinical... ...ensuring compliance with Medicare guidelines. Remote work is available with excellent benefits...Remote work
- ...WPS—A health solutions company is seeking an Appeals Nurse to examine medical records and claims for first-level appeal cases. The RN works closely with Appeals Examiners to... ...license, plus strong communication skills. Remote work options are available in approved...Remote work
- ...A healthcare intelligence organization in Florida is looking for a Medical Review Clinical Appeals Auditor (RN) to conduct Appeals reviews and analyze claims data. The ideal candidate must have an active RN license and relevant experience in provider or payer environments...Remote work
- ...Appeals Processor III - RN ~ salary ~ Unavailable ~ Hours per week ~40 ~ Shifts ~5/8's ~ Start Date ~ Unavailable ~ Duration... ...Appeals Processor III (APP III) to join our dedicated team in a remote capacity. The Appeals Processor III (APP III) is...Remote workContract workFor contractorsFor subcontractorShift work
- Elevance Health is hiring a Nurse Appeals - Licensed Nurse for a full-time virtual position based in multiple locations including Mason,... ...for their resolution. The ideal candidate will possess an active RN license and have experience in a managed-care setting. Elevance...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
$29 - $52 per hour
Texas Health Institute is seeking a motivated RN to assess appeals and medical records, ensuring coverage and billable criteria. This role offers remote work flexibility, primarily within EST and CST hours. The candidate should have a valid RN license, 2+ years of clinical...Remote jobHourly pay$66k - $68k
WPS—A health solutions company is seeking an Appeals Nurse to examine medical records and claims for first-level appeal cases. This role... ...salary range of $66,000-$68,000 depending on experience, with remote work options available in several states. Excellent...Remote job
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