- St. Luke's University Health Network (Allentown, PA)
- …a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all ... for the purpose of appealing proposed DRG and coding changes by insurance providers or their respective auditors JOB DUTIES AND RESPONSIBILITIES: Conduct… more
- Stony Brook University (Stony Brook, NY)
- …services. Perform minor joint procedures. Work with clinic staff together for insurance appeals and pre-authorizations as necessary. Coordination with clinic ... as assigned by the Division Chief or designee. Qualifications Required Qualifications: NURSE PRACTITIONER: NYS license and certification as a Nurse Practitioner.… more
- Luminis Health (Lanham, MD)
- …and administrative personnel for unresolved issues; identifies opportunities for expedited appeals and collaborates with the care coordinator and Physician Advisor ... $34 - $55 USD Luminis Health Benefits Overview: *Medical, Dental, and Vision Insurance *Retirement Plan (with employer match for employees who work more than 1000… more
- MLee Healthcare Staffing and Recruiting, Inc (Redfield, IA)
- Registered Nurse - RN Full-Time / Generous Benefits / Sign-on Bonus We are seeking a highly motivated and compassionate Registered Nurse to join our growing team ... schooling, and year-round community-based activities are among the many appeals to this position. Qualifications: 1 year of clinical...1 year of clinical nursing experience as a Registered Nurse (RN) Associate degree in nursing (ADN) from an… more
- MLee Healthcare Staffing and Recruiting, Inc (Omaha, NE)
- …good schooling, and year-round community-based activities are among the many appeals to this position. Requirement: Registered Nurse current licensure ... Registered Nurse - Cardiac Cath Lab (RN) Are you...Additional benefits: PTO(Paid Time Off) 401(k) Pension Plan Health Insurance Employee Assistance Program (EAP) And more As a… more
- CNY Family Care LLP (Syracuse, NY)
- …first of the month following your date of hire. Practice paid life insurance . Full complement of voluntary benefits. $1,000 annual employer contribution to HSA if ... information is accurately documented in the medical record and that all insurance -required criteria are met for medication approval. Secure prior authorizations for… more
- FloodGate Medical (Tampa, FL)
- …and facilities regarding the coding, billing, prior authorization process, and appeals process for Sonex Health products. Communicate and collaborate with staff ... access personnel at accounts (eg, Surgery Schedulers, Billers, Case Managers, Nurse Coordinators, etc.) Educate healthcare providers and their staff on Market… more
- Heywood Hospital (Gardner, MA)
- …identified. Track and trend opportunities for improvement resulting in late Insurance Reviews, longer lengths of stay; including educating providers to Interqual ... and department policies. Report any variances, trends to director. Submits denials/ appeals when completed to the department secretary for processing. Discharge… more
- Mount Sinai Health System (New York, NY)
- …appeals , On / Off-site Insurance reviews + Implements first step of appeals process to assist Appeals Nurse and Enter Denial information in ... work as per department protocol (IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials +… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …help us transform healthcare? Bring your true colors to blue. The RoleThe Clinical Appeals Nurse Reviewer is responsible for applying sound clinical judgement to ... integral part of the Appeal Review team, the Clinical Appeals Nurse Reviewer will serve as a...comprehensive package of benefits including paid time off, medical/dental/vision insurance , 401(k), and a suite of well-being benefits to… more
- Elevance Health (Tampa, FL)
- ** Nurse Appeals - Medicare** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... an accommodation is granted as required by law. The ** Nurse Appeals - Medicare** is responsible for...term disability benefits, 401(k) +match, stock purchase plan, life insurance , wellness programs and financial education resources, to name… more
- Molina Healthcare (Midvale, UT)
- …appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously ... _For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of...internet connectivity of high speed required._ **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical… more
- State of Colorado (Denver, CO)
- Registered Nurse I - Gilliam Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5008072) Apply Registered Nurse I - ... of Position: Delivers health care to detained and committed youth within the nurse 's scope of practice. Primary care is provided by independent practitioners with… more
- State of Colorado (Denver, CO)
- Charge Nurse RN II - CO Mental Health Hospital in Fort Logan (S. Denver) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5021723) Apply Charge ... Nurse RN II - CO Mental Health Hospital in...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Denver, CO)
- CDOC Mid Level Provider / Nurse Manager - (DENVER) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5019611) Apply CDOC Mid Level Provider / ... Nurse Manager - (DENVER) Salary $8,788.00 - $12,302.00 Monthly...Short and long term disability coverage; + Paid life insurance ; + 11 paid holidays per year plus vacation… more
- State of Colorado (Pueblo, CO)
- Registered Nurse I - Nursing Residency Program - CMHHIP - Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5007135) Apply Registered ... Nurse I - Nursing Residency Program - CMHHIP -...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Pueblo, CO)
- Registered Nurse II- CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5003548) Apply Registered Nurse II- CMHHIP Salary $45.99 - ... + Description + Benefits + Questions Department Information Registered Nurse II-Full Time CMHHIP This posting will be used...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (Pueblo, CO)
- Registered Nurse I - CMHHIP Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4999328) Apply Registered Nurse I - CMHHIP Salary $43.80 - ... + Description + Benefits + Questions Department Information Registered Nurse I-Full Time CMHHIP This posting will be used...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- State of Colorado (CO)
- CDOC Registered Nurse ( Nurse I) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4963973) Apply CDOC Registered Nurse ( Nurse I) ... Monthly Location Statewide, CO Job Type Full Time Job Number CAA Nurse I Statewide 06/2025 Department Department of Corrections Division Clinical and Correctional… more
- State of Colorado (Denver, CO)
- Assistant Nurse Manager - Nurse III -...of the department's action. For more information about the appeals process, the official appeal form, and how to ... Fort Logan (S. Denver) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5012615) Apply Assistant Nurse Manager - Nurse III - Colorado… more
