This Appeal Coordinator position is responsible for medical appropriateness review of and the coordination of appeal reviews by peer consultants. The primary responsibility...  .... The Appeals Coordinator will use clinical support criteria and/or established department... 
Suggested
Holiday work
Immediate start
Weekend work

Independence

Philadelphia, PA
more than 2 months ago
 ...by U.S. News & World Report. Our clinical expertise, state-of-the-art diagnostic...  ...Utilization Coordinator provides utilization review, Amkai chart surveillance and denials...  ...review denied claims and assists with the appeals process. Performs other related... 
Suggested
Part time
Worldwide

Wills Eye Hospital

Philadelphia, PA
2 days ago
Thoroughly researches and investigates appeals Reviews appeal documentation to ensure all pertinent information is included Makes member and provider outreach calls to gather information and answer questions Makes outreach to other departments to confirm rules and guidelines... 
Suggested

Independence

Philadelphia, PA
4 days ago
The Supervisor of Appeals will lead a team of Appeal Specialists and Appeal Coordinators who process clinical and non-clinical appeals, and claim review requests, from all provider types, as well as clinical and non-clinical appeals and claim review requests from members... 
Suggested

Independence

Philadelphia, PA
a month ago
 ...development of coding policies and procedures. Coordinates and conducts reviews of targeted cases to assure timely billing process and correct...  ...health, medicine and social science. Jefferson Health, the clinical arm of Thomas Jefferson University, has grown from a three-... 
Suggested

Jefferson Health

Philadelphia, PA
1 day ago
 ...buying group, and a leader in digital communications. Web: | Facebook: | Twitter: Job Description The Manager, Regulatory Review manages a team of Associates and Senior Associates to ensure marketing materials for a client (or group of clients) follow the... 
Suggested
Flexible hours
Shift work
3 days per week

Digitas Health

Philadelphia, PA
10 days ago
The Appeals Specialists investigates the appeal requests, gathers all pertinent information to ensure the appeals committee can provide...  ...established by State and other regulatory agencies. Reviews appeal case documentation within the appeal management system to... 
Suggested

Independence

Philadelphia, PA
more than 2 months ago
 ...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. The... 
Suggested
Holiday work
Temporary work
Relocation bonus
Flexible hours
Day shift
Monday to Friday

American Red Cross

Philadelphia, PA
1 day ago
oPerforms daily quality assessments for all function areas of the Appeals and Grievances Department to assure the integrity of processes – for all lines of business. oReviews include assessments of the decision-making process through the life of the appeal and assuring... 
Suggested

Independence

Philadelphia, PA
more than 2 months ago
 ...workforce, and the residents whom we serve and promote an environment of comradery, accountability, and inclusiveness. Attorneys in the Appeals Unit of the Law Department represent the City in most appellate matters before state and federal courts. The Unit handles appeals... 
Suggested
Holiday work
Full time
Local area

City of Philadelphia

Philadelphia, PA
10 days ago
 ...Job Description Job Description Document review project currently in progress. This is remote work for a Philadelphia area law firm. Must be located within Pennsylvania. Must have an active attorney license in any state Must have a PC/Mac Business hours... 
Suggested
Remote job
Shift work

Wegman

Philadelphia, PA
26 days ago
 ...The essential functions, duties, and responsibilities include, but are not limited to the following: Data entry, annotation and review of documentation submitted for various administered projects. Recognize discrepancies or lack of information within claim documentation... 
Suggested
Full time
Contract work
Immediate start
Remote job
Flexible hours

Angeion Group LLC

Philadelphia, PA
10 days ago
Marshall Dennehey is searching for an Appeals Coordinator with at least 2 years of experience to join our Philadelphia or King of Prussia office. The accepted candidate will join a growing team responsible for coordinating research, managing deadlines, innovating procedures... 
Suggested

Marshall Dennehey

Philadelphia, PA
1 day ago
 ...Job Description Clinical Director The Physical Therapist Clinical Director is responsible for complete oversight of operations and...  ...Education reimbursements MedBridge Membership Yearly review for growth opportunities Professional Development Growth Tracks... 
Suggested
Full time
Relocation bonus

JAG Physical Therapy

Philadelphia, PA
9 days ago
 ...accessibility, integrity, and quality care are what is most important. We put a lot of emphasis on the thought that—in order for our clinical team to be accessible to clients—we must fully support our clinicians by allowing them to do what they are trained to do. We... 
Suggested
Part time
Private practice
Relocation bonus

Thriveworks

Philadelphia, PA
16 hours ago
 ...Experienced Document Review Attorney – Remote Great opportunity for l icensed attorneys with document review experience interested in quality focused e-Discovery. We have some projects anticipated to start soon and others in the pipeline.  Please apply to get on... 
Remote job
Hourly pay
Full time
Flexible hours

Dauntless Discovery

Philadelphia, PA
12 days ago
 ...HYBRID FLEXIBILITY Description: Responsibilities The Clinical Research Nurse III performs basic nursing skills, study coordination...  ...Skills: Clinical research, adverse event reporting, Chart review, Oncology, Epic, Pharmaceutical, Research center, Gcp... 

Actalent

Philadelphia, PA
2 days ago
In collaboration with the patient/family, physicians, and the interdisciplinary team, the Case Manager facilitates the patient's progress through the acute episode of care in an efficient and cost effective manner. Monitors the level of care, initiating evidence based protocols...

Temple University

Philadelphia, PA
1 day ago
 ...Clinical Coordinator Nursing * JOB SUMMARY * The Nursing Clinical Coordinator actively participates in a collaborative/consultative/supportive role with the Chief Nursing Officer, Administrators and Nurse Managers to assure efficient patient flow and quality patient... 
Work experience placement
Immediate start
Shift work

Good Shepherd Rehab

Philadelphia, PA
1 day ago
 ...Job Description CLINICAL DIETITIAN II - ENDOCRINOLOGY - \n \n Seeking an experienced Pediatric Clinical Registered Dietitian (RD) to provide medical nutrition therapy (MNT) to pediatric patients. \n Direct Hire \n Full-Time \n Competitive Compensation,... 
Full time
Relocation package

Job Juncture

Philadelphia, PA
5 days ago
 ...Clinical Supervisor Philadelphia PA Master s Degree in psychology, social work or a related field required LCSW, LPC, or CAADC preferred Experience with treatment of persons living with Co-Occurring Disorders preferred Provide clinical supervision to up to eight... 
Full time

FCS, Inc

Philadelphia, PA
16 hours ago
 ...function test (PFTs), arterial flow Doppler studies, and other clinical diagnostic studies assigned to meet the needs of the organization...  ..., post appointment information), and filing Data entry and review of computerized worksheets manually completed by claimants... 
Local area
Flexible hours

All Medical Personnel

Philadelphia, PA
4 days ago
 ...from you and discussing the opportunity! The Role: The Clinical Research Coordinator will support such researchers providing...  ..., OR, and PI •Ensure established procedures are utilized in reviewing the collection of clinical data and the administration of clinical... 
Holiday work
Contract work
Temporary work
Flexible hours

KP Recruiting Group

Philadelphia, PA
2 days ago
GDIT - Senior Full Stack - Code Review / Security Specialist How the Senior Full Stack - Code Review / Security Specialist will make an impact: Architecting, designing, coding, testing, implementing and troubleshooting Windows and web based software solutions in T-... 
Holiday work
Permanent employment
Immediate start
Remote job
Worldwide

General Dynamics Information Technology

Philadelphia, PA
18 days ago
 ...Health Services (IBHS) has an immediate opening for an License Clinical Supervisor. License Clinical Supervisor Salary: $55,000...  ...to clinicians and Behavioral Health Technicians while reviewing areas of needed improvement. Track and monitor the completion... 
Full time
For contractors
Local area
Immediate start

Comhar Inc.

Philadelphia, PA
3 days ago
 ...Grade: N03 (Union rates based on experience). Summary: The Clinical Research Nurse will perform nursing assessments and procedures...  ...conducting comprehensive nursing assessments, obtaining vital signs, reviewing medications, documenting patient information/instructions in... 
For contractors
Local area
Remote job
Flexible hours
Weekend work
Afternoon shift

Temple University Hospital - Episcopal Campus

Philadelphia, PA
1 day ago
Overview: Applicants should possess either of the following Clinical Licensures : LCSW, LPC, LMFT or LCADC We need hope-...  ...of care, and state regulations Participate in funding source reviews and make recommendations for treatment and lengths of stay Provide... 
Holiday work
Temporary work
Weekend work
Afternoon shift

Gaudenzia

Philadelphia, PA
1 day ago
Responsible for the clinical operations of a project within a defined regional/global level. Provides oversight of project deliverables...  ...actions. The COL will develop study tools for site and CRA use, review visit reports, review and track protocol deviations, and... 
Permanent employment
Temporary work
Local area
Work from home

Alimentiv

Philadelphia, PA
2 days ago
 ...Pediatric RN- Outpatient Clinic Company Overview Shriners Children's is a family that respects, supports, and values each other. We are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster... 
Holiday work
Local area
Shift work
Weekday work

Shriners Hospitals for Children - Philadelphia

Philadelphia, PA
2 days ago
 ...Research and Innovation (CRI) has been a world leader in radiology clinical research for over 50 years. Over this period, the CRI has...  ...initiatives across the College. Principal duties include: Review protocols and coordinate study set-up activities for trials... 
Remote job
For contractors
Flexible hours

American College of Radiology

Philadelphia, PA
16 hours ago