- Elevance Health (Costa Mesa, CA)
- ** Nurse Appeals ( RN )** **Location** : This role requires associates to be in-office **1-2** days per week, fostering collaboration and connectivity, while ... may be considered. **Shift: Monday to Friday from 8:00am-5:00pm PST** The ** Nurse Appeals ** is responsible for investigating and processing medical necessity… more
- Elevance Health (Tampa, FL)
- ** Nurse Appeals ** **Location** : **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... skill development. **Expected Work Hours: Monday-Friday OR Tuesday-Saturday; 8am-5pm** The ** Nurse Appeals ** is responsible for investigating and processing… more
- HCA Healthcare (Brentwood, TN)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Appeals Nurse RN you want with your current employer? We have an exciting ... colleagues. Do you want to work as a Clinical Appeals Nurse RN where your...qualifications you will need:** + Currently licensed as a Registered Nurse ( RN ) in the… more
- R1 RCM (Salt Lake City, UT)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Appeals Nurse ** , you will help our hospital clients by ... **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct a detailed review...at telephonic hearings if needed. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
- Molina Healthcare (Tacoma, WA)
- … 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
- R1 RCM (Chicago, IL)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical ... what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical...external compliance deadlines are met. **Required Skills:** + Active Registered Nurse license + An active CCS,… more
- Evolent (Providence, RI)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
- Actalent (Rancho Cordova, CA)
- Job Title: Registered NurseJob Description The Commercial Appeals and Grievance Registered Nurse ( RN ) reviews and processes appeals resulting ... other nationally recognized sources such as NCCN and ACOG. The RN reviews appeals for benefits, medical necessity, coding accuracy, and medical policy… more
- State of Colorado (Golden, CO)
- Registered Nurse I, RN I...of the department's action. For more information about the appeals process, the official appeal form, and how to deliver ... Mountain, Youth Services Center - Golden Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4935383) Apply Registered Nurse I, RN I -… more
- Select Medical (Los Angeles, CA)
- …Cedars, UCLA and Select Medical Century City / Los Angeles, CA Case Manager (CM) - Registered Nurse ( RN ) or Social Worker (LCSW) **Per Diem** **Pay Rate: ... valid state licensure in Social Work required or Current state licensure as a Registered Nurse required. + Previous experience in Case Management and Discharge… more
- Sutter Health (Sacramento, CA)
- …: **EDUCATION:** Graduate of an accredited school of nursing **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California **TYPICAL EXPERIENCE:** 2 years ... **Organization:** SMF-Sutter Med Foundation- Central **Position Overview:** The Grievances & Appeals Specialist RN supports the patient and family experience… 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
- 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/4762850) Apply CDOC Registered Nurse ( Nurse I) Salary $7,442.00 Monthly Location Statewide,… more
- State of Colorado (Denver, CO)
- CDOC Registered Nurse - Part-time - Denver 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/4945982) Apply CDOC Registered Nurse - Part-time - Denver Salary...Colorado? If so, what state issued your license? 07 Nurse Licensure Compact: If appointed to an RN… 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
- Atlantic Health System (Union, NJ)
- …quality patient care. + Information Management: Utilizes computer systems as required. + The Registered Nurse ( RN ) in the ambulatory practices functions as ... familiarity with Botox procedures and associated authorizations is preferred. Registered Nurse : Accountabilities: + Budget Responsibility: Assists...RN provides care in accordance with the NJ Nurse Practice Act. + The RN must… 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/4942901) 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
- Actalent (Rancho Cordova, CA)
- …documentation and provide clear rationale for decisions. Required Qualifications: + Licensure: Active Registered Nurse ( RN ) license in the state of ... Hiring a Registered Nurse for a great healthcare...Hiring a Registered Nurse for a great healthcare company in CA...Position Summary: We are seeking four experienced and detail-oriented Registered Nurses (RNs) to join the Appeals … more
- Intermountain Health (Billings, MT)
- **Job Description:** The Registered Nurse ( RN ) is a professional caregiver who assumes responsibility and accountability for assessing, planning, ... implementing and evaluating care of patients. The Clinic RN utilizes the nursing process by use of technology,...an accredited school of nursing is required + Current/valid Registered Nurse license from the state licensing… more