Average salary: $85,149 /yearly
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...technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration.
As our **Clinical Coding Appeals Nurse** , you will help review and interpret medical records to draft appeals of denied and underpaid claims. Every day you...
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...who changes everything for our 28 million members as a clinical professional on our Medical Management/ Health... ...offering competitive benefits including a fresh perspec Clinical, Clinician, Appeals, Medical Director, Practical Nurse, Vocational Nurse, Healthcare...
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...everything for our 28 million members as a clinical professional on our Medical Management/... ...for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing... ...Graduate from an Accredited School of Nursing or Bachelors degree in Nursing and 2 4...
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Hourly pay
Holiday work
Remote job
Flexible hours
...Clinical Coding Appeals Author at R1 RCM in Boise, Idaho, United States Job Description As a Clinical Coding Appeals Author , you will help review and interpret medical records to draft appeals of denied and underpaid claims. Every day you will, review medical records...
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...for the management and communication of denials/appeals received from third party payers, managed care companies... ...will be a liaison and point of contact for clinical denials and appeal inquiries. The Clinical Appeals Nurse will review each case identified/referred for appeal...
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Full time
For contractors
...RN - Grievance and Appeals Clinical Reviewer
5297 W Copans Rd, Margate, FL 33063, USA
Req #461
Monday, April 29, 2024
Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare...
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...Washington, D.C., Puerto Rico and the United Kingdom.
The Atlantic Region CBO is seeking a dynamic and talented Clinical Documentation Improvement (CDI) Nurse.
The Clinical Documentation Improvement (CDI) Nurse provides clinically based concurrent and retrospective...
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Local area
...Manager of Clinical/Coding Appeals & Denials at R1 RCM in Boise, Idaho, United States Job Description As our Manager of Clinical/Coding Appeals & Denials, you will serve as an expert on appeals and denials management. This role will represent client hospitals where claims...
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Holiday work
Temporary work
For contractors
Local area
...Part of a multidisciplinary team, responsible for clinical oversight of assigned grievance and
appeal cases. Utilizes clinical judgement in the assessment... ...May serve as a backup to absent Grievance & Appeals Nurse Specialists
Attends meetings as needed including...
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Immediate start
Remote job
Join a team of dynamic, results oriented professionals!
Named among "The World's Most Admired Companies" by Fortune Magazine
Named among "America's 100 Most Trustworthy Companies" by Forbes magazine
Named among "Great Places to Work" by Becker's Hospital...
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Holiday work
Flexible hours
...time off
~ Eight Paid Holidays per year
~ Quarterly incentive plans
*The Akron, OH billing center has multiple openings for Appeals Representatives. These are remote, work-from-home positions*
JOB DESCRIPTION OVERVIEW:
~ The Denials & Appeals...
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Remote job
Work from home
...investigate member and provider medical necessity appeals
Review prospective, inpatient, and... ...resolved in a timely manner
Prepare clinical reviews and provides monitoring of cases... ...RN license preferred
AS/BS in Nursing
The posted pay scale represents the...
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...order to maximize revenue for TriHealth. This includes analysis of clinical information presented with comparison to established national... ....
Job Requirements:
Associate's Degree or Diploma in Nursing
New hires required to obtain BSN within 5 years of hire
Registered...
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...appropriate.
Provide correction suggestions to other departments so the invoice can be resubmitted.
Provide coding direction to appeal invoices and/or submit appeals via payer website or fax, as directed.
Complete reconsideration letters as needed.
Complete...
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Holiday work
Flexible hours
Vice President Clinical Service - Utilization Management & Appeals
Oregon, Washington, Idaho, Utah
Primary Job Purpose
The Vice President Clinical Services is a member of the Health Services Organization (HSO) leadership team focused on enabling members to achieve...
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Work from home
...RN Clinical Nurse
Please use Google Chrome or Mozilla Firefox when accessing Candidate Home.
By joining the American Red Cross you... ...You can make a difference by volunteering in a position that appeals to you and allows you to use your unique skills and talents....
Holiday work
Temporary work
Relocation bonus
Flexible hours
Day shift
Monday to Friday
Job Type
Full-time
Description
Job purpose
~ The Appeals Specialist is responsible for managing insurance denials by reviewing claims and clinical documentation, posting payments, handling correspondence letters and writing appeals to correct payment amount...
Full time
Work experience placement
Local area
...Job Summary:
The Clinical Appeals Nurse is responsible for the completion of clinical appeals and state hearings from all states.
Essential Functions:
Responsible for the completion of clinical appeals and state hearings from all states
Review and complete...
Remote job
Full time
...spent on the particular responsibility - High to Low
1.
Manages workflow for Humana PPI Audits, RAC Audits, or Outpatient Appeals and communicates daily with Sr. Director/Manager on trends identified
2.
Responds to queries within 72hrs, appropriately documents...
...is seeking individuals who combine excellent problem-solving skills with the ability to function effectively both as part of a team or on an individual basis to bring their talent to our team. Wipro is a leading global IT so Appeals, Examiner, Technology, Healthcare...
