- R1 RCM (Detroit, MI)
- …platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Nurse ** , you will help our ... remote, production-driven position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct a detailed review of patient medical… more
- Molina Healthcare (Sterling Heights, MI)
- …for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical decisions… more
- R1 RCM (Detroit, MI)
- …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
- R1 RCM (Detroit, MI)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Supervisor** , you will help support clinicians ... position. **Here's what you will experience working as a Clinical Appeals Supervisor:** + Track and monitor...additional support and engagement. **Required Skills:** + Active Registered Nurse license For this US-based position, the base pay… more
- Corewell Health (Farmington Hills, MI)
- …criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization ... management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan License Upon Hire required How Corewell… more
- Molina Healthcare (Sterling Heights, MI)
- …Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to the enterprise. Primary responsibilities will include ... specialized medical necessity reviews and/or appeals and supporting market performance. Performance activities include physician...other areas of the organization for their area of clinical specialization. Team 1: Transplant (PST) Team 2: NICU… more