- Molina Healthcare (Madison, WI)
- **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal appeals clinical processes - ensuring that ... to provide quality and cost-effective member care. Candidates with UM and Appeals experience are highly preferred...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- …Fault, and Worker's Compensation cases to validate related care for reimbursement. Conducts clinical appeals as required by the third-party payers to overturn ... Patient Accounting Centers (CPAC) for revenue reimbursement. The RUR nurse applies advanced clinical knowledge, communication skills,...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Molina Healthcare (Madison, WI)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Madison, WI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are… more