- R1 RCM (Chicago, IL)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical ... position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to appeal denied and underpaid… more
- Rush Copley Medical Center (Aurora, IL)
- **Position Summary** : 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...focus on Resolute Hospital Billing. **POSITION REQUIREMENTS** **License:** Registered Nurse (RN) in the State of IL with at… more
- Elevance Health (Chicago, IL)
- …and providers. **Job Summary:** + Perform physician-level case review, following initial nurse review, of Medical Oncology regimens and supportive care. + Perform ... physician-level case review, following initial nurse review, of chemotherapy regimens. + Determine medical necessity...a subject matter expert. + Perform first level provider appeals as designated by the client for adverse determinations.… more
- Centene Corporation (Springfield, IL)
- …long term care services + Assist member with filing and resolving complaints and appeals + Performs other duties as assigned + Complies with all policies and ... standards **Education/Experience:** Bachelor's degree or Registered Nurse License and 2+ years of care management experience,...and 2+ years of care management experience, Licensed Practical Nurse and 4+ years of care management experience, or… more
- Centene Corporation (Springfield, IL)
- …long term care services + Assist member with filing and resolving complaints and appeals + Performs other duties as assigned + Complies with all policies and ... standards **Education/Experience:** Bachelor's degree or Registered Nurse License and 2+ years of care management experience,...and 2+ years of care management experience, Licensed Practical Nurse and 4+ years of care management experience, or… more
- Centene Corporation (Springfield, IL)
- …long term care services + Assist member with filing and resolving complaints and appeals + Performs other duties as assigned + Complies with all policies and ... standards **Education/Experience:** Bachelor's degree or Registered Nurse License and 2+ years of care management experience,...and 2+ years of care management experience, Licensed Practical Nurse and 4+ years of care management experience, or… more
- Centene Corporation (Chicago, IL)
- …long term care services. + Assist member with filing and resolving complaints and appeals + Performs other duties as assigned. + Complies with all policies and ... standards **Education/Experience:** Bachelor's degree or Registered Nurse License and 2+ years of care management experience,...and 2+ years of care management experience, Licensed Practical Nurse and 4+ years of care management experience, or… more
- Centene Corporation (Springfield, IL)
- …long term care services + Assist member with filing and resolving complaints and appeals + Performs other duties as assigned + Complies with all policies and ... standards **Education/Experience:** Bachelor's degree or Registered Nurse License and 2+ years of care management experience,...and 2+ years of care management experience, Licensed Practical Nurse and 4+ years of care management experience, or… more
- Lundbeck (Deerfield, IL)
- …of seamless, patient-centric support capabilities (including: case management, hub, copay, nurse and reimbursement) to help patients gain and maintain appropriate ... the resolution of reimbursement issues (insurance changes, prior authorizations, appeals , other) according to established SOPs. + Collaborate with stakeholders… more