- R1 RCM (Chicago, IL)
- …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
- Rush Copley Medical Center (Aurora, IL)
- …The Appeals Specialist RN reviews inpatient hospital denials, clinical validation requests, and upheld denials after physician-to-physician (P2P) discussions ... then conducts appeals , as appropriate. Monitors and tracks denial outcomes with...insurance companies and revenue cycle leadership to prevent future clinical denials by communicating denial root causes and help… more
- Elevance Health (Chicago, IL)
- ** Clinical Operations Medical Director** **Utilization Management of Medical Oncology Benefits** **Carelon Benefits Management** **$20,000 Sign On Bonus** ... Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology._ The ** Clinical … more
- Sharecare, Inc. (Chicago, IL)
- …available 3rd parties for care management and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and ... enrollment / new hire plan selection, claims issues, ID card issues, grievances/ appeals , utilization management (UM) status, including but not limited to medical,… more
- Centene Corporation (Chicago, IL)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... long term care services. + Assist member with filing and resolving complaints and appeals + Performs other duties as assigned. + Complies with all policies and… more