- Prime Therapeutics (Phoenix, AZ)
- …and drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description Summary** Under supervision, is responsible for performing ... web-based application and spreadsheets. + Supports clinical services such as the appeals program. + Participates in meetings and consults with management on regular… more
- Sharecare, Inc. (Phoenix, AZ)
- …or assist member in working with payer to complete prior authorization or appeals process, when necessary. + Abide by Clinical Advocacy Program Description and ... patient and provider outcomes **Qualifications:** + Current multi-state/compact Registered Nurse licensure in state of residence is required, with ability… more
- Sharecare, Inc. (Phoenix, AZ)
- …enrollment / new hire plan selection, claims issues, ID card issues, grievances/ appeals , utilization management (UM) status, including but not limited to medical, ... 3rd parties for: + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status +...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- Sedgwick (Phoenix, AZ)
- …client or facility to obtain additional or missing information. + Handles provider appeals as appropriate to fee schedule and contractual disputes. + Identifies and ... review experience in multi-state jurisdiction; prior experience in PPO provider appeals , re-pricing, surgery review, by report and RNE review; two (2)… more
- Mindful Support Services (Tempe, AZ)
- …Therapy Group is a company dedicated to empowering therapists, psychologists, and nurse practitioners to dive into private practice, without doing all the leg ... calls and portal navigation + Claims reprocessing requests, corrected claims, and appeals + Navigating many commercial insurances such as Blue Cross/Blue Shield,… more