- State of Colorado (Denver, CO)
- …(HP III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4966056) Apply Registered Nurse Health Compliance Inspector Home Care - ... Registered Nurse Health Compliance Inspector Home Care -...FAA00601 (HP III RN ) Salary $72,336.00 Annually Location Denver, CO Job Type Full Time… more
- State of Colorado (Denver, CO)
- …III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4966096) Apply Registered Nurse Health Compliance Inspector, Nursing ... Registered Nurse Health Compliance Inspector, Nursing...Facilities - FAA00392 (HP III RN ) Salary $72,336.00 Annually Location Denver, CO Job Type… more
- Ascension Health (Jacksonville, FL)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse obtained prior to hire date or job transfer ... related to coding, medical records/documentation, precertification, reimbursement and claim denials/ appeals . + Assess and coordinate discharge planning needs with...date. Licensed as a Registered Nurse in Florida. Credentialed from State… more
- Ascension Health (Tulsa, OK)
- …management rules and regulations. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Oklahoma Board of Nursing ... related to coding, medical records/documentation, precertification, reimbursement and claim denials/ appeals . + Assess and coordinate discharge planning needs with… more
- Elevance Health (Seattle, WA)
- **Manager II Grievance/ Appeals ( RN )** **Location** : **Hybrid 2:** This role requires associates to be in-office **3** days per week, fostering collaboration and ... considered. **Expected Work Hours:** Monday-Friday; 8am-5pm PST The **Manager II Grievance/ Appeals ** is responsible for management oversight of grievances and … more
- Ascension Health (Wichita, KS)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing ... related to coding, medical records/documentation, precertification, reimbursement and claim denials/ appeals . + Assess and coordinate discharge planning needs with… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary:** Investigate and resolve medical necessity member appeals . Ensure compliance with state and federal ... Centers for Medicare and Medicaid Services requirements. Maintain all appeals documentation according to external agency requirements. **Supervision Exercised:** +… more
- State of Colorado (Sterling, CO)
- CDOC Registered Nurse - Part-time - Sterling Print...Yes + No 06 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4756062) Apply CDOC Registered Nurse - Part-time - Sterling Salary...Colorado? If so, what state issued your license? 07 Nurse Licensure Compact: If appointed to an RN… more
- Molina Healthcare (Provo, UT)
- … appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of ... these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- State of Colorado (CO)
- CDOC Registered Nurse ( Nurse I) Print...RN license. 07 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4963973) Apply CDOC Registered Nurse ( Nurse I) Salary $7,442.00 Monthly Location Statewide,… more
- Sacramento County (Sacramento, CA)
- Supervising Registered Nurse D/CF Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/448883) Apply Supervising Registered Nurse ... are at 5:00 pm on: 2/3/25, 4/7/25, 6/2/25, 8/4/25, 10/6/25, 12/1/25 Supervising Registered Nurse - Detention/Correctional Facility is the first level supervisory… more
- Sacramento County (Sacramento, CA)
- …read and understood the above instructions. 02 Select the one box that best describes your Registered Nurse ( RN ) license issued by the State of California. + ... Registered Nurse D/CF (Level I/II) Print...Street, Room 2640, Sacramento, CA 95814, telephone: ###. Such appeals must be filed within thirty (30) calendar days… more
- MaineGeneral Health (Augusta, ME)
- Job Summary: MaineGeneral Health is seeking a qualified RN Clinical Appeals Specialist to support our Revenue Cycle team by reviewing denied insurance claims and ... alignment with MaineGeneral's mission of exceptional patient care Job Description: Position: RN Clinical Appeals Specialist Location: Alfond Center for Health,… more
- Guardian Life (Bethlehem, PA)
- The **Senior RN Clinical Consultant** will work in partnership with Clinical and Vocational Leaders to provide ongoing coaching and oversight to Clinical Consultants ... clinical subject matter expert in all lines of business (STD/LTD/ Appeals ) and products, action planning management, and Guardian systems....of 5 years in direct patient care settings + RN REQUIRED, BSN and CCM preferred + Demonstrated proficiency… more
- Ochsner Health (New Orleans, LA)
- …- Experience in Appeal/Denial Management **Certifications** Required - Current State of Louisiana Registered Nurse ( RN ) License Preferred - Certification in ... relates to all medical necessity audits. **Education** Required - Registered Nurse Diploma Preferred - Associate's or...experience in the delivery of patient care as an RN . Experience in Case Management, Utilization Review and/or Discharge… more
- State of Colorado (Denver, CO)
- Registered Nurse I-Colorado Mental Health Hospital in Fort Logan-Denver Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4969227) Apply ... Registered Nurse I-Colorado Mental Health Hospital in...of the department's action. For more information about the appeals process, the official appeal form, and how to… more
- ERP International (Barksdale AFB, LA)
- **Overview** ERP International is seeking a **Utilization Management Registered Nurse ( RN )** for a full-time position supporting the 2d Medical Group, ... (e) and (o). After following the directed methodology for appeals , the MTF will also adhere to its respective...4 (CPT-4) coding. Licensure:** Current, full, active, and unrestricted RN license from any state. Life Support Certifications:** AHA… more
- City and County of San Francisco (San Francisco, CA)
- …range of mental health and substance use treatment services. The purpose of the 2320 Registered Nurse Training Programs is to prepare registered nurses at ... By applying to this job ad for the 2320 Registered Nurse Training Programs, you will be...may be appealed under Civil Service Rule 110.4. Such appeals must be submitted in writing to the Department… more
- City and County of San Francisco (San Francisco, CA)
- …LICENSE: Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License (**IMPORTANT: Be sure to include your ... California RN license number in the application, as failure to...least one (1) year of experience working as a Registered Nurse SPECIALTY REQUIREMENTS: + Clinical Documentation… more
- City and County of San Francisco (San Francisco, CA)
- …License: Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License (**IMPORTANT: Be sure to include your ... California RN license number in the application, as failure to...least one (1) year of experience working as a Registered Nurse . One-year fulltime employment is equivalent… more
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