- R1 RCM (Detroit, MI)
- …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Nurse ** , you will help our ... remote, production-driven position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct a detailed review of patient medical… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you will help ... remote production-drive position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to… more
- R1 RCM (Detroit, MI)
- …Doctor (MD) or Doctor of Osteopathic Medicine (DO) medical license or be a registered nurse with strong appeals experience + At least 2 years of clinical ... and cash flows while reducing operating costs and enhancing the patient experience. The Appeals Author within Physician Advisory Services will serve as an expert on … more
- McLaren Health Care (Detroit, MI)
- …(inpatient vs. outpatient) based on medical necessity. Actively seeks additional clinical documentation from the physician to optimize hospital reimbursement when ... payer requirement. 5. Documents in the electronic medical record (EMR): clinical reviews (medical necessity), payer authorizations, avoidable days, readmission risk… more
- University of Michigan (Ann Arbor, MI)
- …care areas. The position is unique in that it combines clinical /quality considerations with regulatory/financial/utilization review demands. The position creates a ... balance between individual clinical needs with the efficient and cost effective utilization...Cycle/HIM regarding RAC decision to appeal, denials; input into appeals ; share findings with providers + Review all cases… more
- Corewell Health (Dearborn, MI)
- …criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization ... Level II trauma center and has been recognized for clinical excellence and innovation in the fields of orthopedics,...review, home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan License Upon Hire… more
- Corewell Health (Grosse Pointe, MI)
- …criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization ... management, utilization review, home care and/or discharge planning. Preferred + LIC-Registered Nurse (RN) - STATE_MI State of Michigan Upon Hire required +… more