- US Tech Solutions, Inc. (Columbia, SC)
- Job Title: Licensed Practical Nurse Location: Columbia SC 29229 Duration: 3+ Months Contract (No End date) Job Description: . Monday-Friday 8:30-5pm. CONTRACT ONLY . ... of professional, inpatient or outpatient, facility benefits or services, and appeals . Documents decisions using indicated protocol sets or clinical guidelines.… more
- Compass Health Network (Warrensburg, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... ensure our clients are taken care of. An Outpatient Nurse will have a Monday through Friday schedule with...with a rotating weekend schedule (if needed). Responsibilities Include: Nurse will plan, organize, and coordinate their medication clinic… more
- Compass Health Network (Sullivan, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... but may also provide coverage to Union, Cuba, and Owensville. Responsibilities Include: Nurse will plan, organize, and coordinate their medication clinic Nurse … more
- Compass Health Network (Arnold, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... ensure our clients are taken care of. An Outpatient Nurse will have a Monday through Friday schedule with...with a rotating weekend schedule (if needed). Responsibilities Include: Nurse will plan, organize, and coordinate their medication clinic.… more
- Compass Health Network (Sullivan, MO)
- …interest you, if running a Medication Clinic and acting as a case manager appeals to you! Our Compass Health Network Nursing Staff use the Compass "Champion" ... may also provide coverage to Union, Cuba, and Owensville. Responsibilities Include: Nurse will plan, organize, and coordinate their medication clinicNurse will be… more
- RestoraCare Staffing (Houston, TX)
- RestoraCare Staffing is seeking a Registered Nurse (RN) Case Management for a nursing job in Houston, Texas.Job Description & RequirementsSpecialty: Case ... Current and valid license to practice as a Registered Nurse in the state of Texas or Current and...case, excess days, resource utilization, readmission rates, denials and appeals . Uses data to drive decisions and plan/implement performance… more
- CHRISTUS Health (Alamogordo, NM)
- …Medicare Conditions of Participation, DNV standards, HIPAA, and reporting requirements. Submits appeals in a timely manner, upon request by the Director. Initiates ... and reporting individual cases and/or trends to the infection control nurse . Performs utilization management functions as required by payer source. Complies… more
- Elevance Health (Hendersonville, TN)
- ** Nurse Appeals - Licensed Nurse ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live in the state of ... Louisiana within 50 miles of one of our PulsePoint locations. The ** Nurse Appeals ** is responsible for investigating and processing and medical necessity … more
- Elevance Health (Los Angeles, CA)
- ** Nurse Appeals - Licensed Nurse ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live in the state of ... locations. **Shift:** Monday to Friday from 8:00-5:00 pm PT The ** Nurse Appeals ** is responsible for investigating and processing and medical necessity … more
- Elevance Health (Costa Mesa, CA)
- ** Nurse Appeals - California candidates only** **Location: This is a virtual position and prefer candidates reside within 50 miles of an Elevance Health ... make an impact:** Responsible for investigating and processing and medical necessity appeals requests from members and providers. **Primary duties may include, but… more
- Kepro (Indianapolis, IN)
- …solutions in the public sector. Acentra is currently looking for a Utilization Management Appeals Nurse - LPN/RN to join our growing team. Job Summary: Our ... Utilization Management Appeals Nurse - LPN/RN will help orchestrate the seamless resolution of appeals in line with health regulations. He or She will… more
- CareFirst (Owings Mills, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding ... adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes clinical skills and knowledge of all applicable State and Federal rules and… more
- Penn State Health (Hershey, PA)
- …Kieffer at ###@pennstatehealth.psu.edu 100% Remote Position **SUMMARY OF POSITION:** The clinical appeals nurse will be responsible for reviewing all clinical ... Hospitals. This will include all Pre-pay and Post-pay audit denials. The appeals nurse will subsequently draft any required appeals until the process… 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 ... caring group of colleagues. Do you want to work as a Clinical Appeals Nurse RN where your passion for creating positive patient interactions are valued? If… 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 ... production-driven position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct a detailed review of patient medical records and… more
- CVS Health (Hartford, CT)
- …position are Monday-Friday 8a-5p in time zone of residence. Position Summary The Appeals Nurse Consultant position is responsible for processing the medical ... necessity of Medicare Part C appeals from both members and providers. This role is...a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties may include,… more
- CVS Health (Hartford, CT)
- …or 9-6 in designated time zone) with occasional weekends and holidays. The Appeals Nurse Consultant position is responsible for processing the medical necessity ... of Medicare Part C appeals from both members and providers. This role is...a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties may include,… more
- R1 RCM (Boise, ID)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical ... position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to appeal denied and underpaid… more
- CVS Health (Hartford, CT)
- …residence with occasional rotational weekend and holiday coverage. Position Summary The Appeals Nurse Consultant position is responsible for processing the ... medical necessity of Medicare Part C appeals from both members and providers. This role is...a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties may include,… more
- CVS Health (Hartford, CT)
- …business hours 8a-5p in time zone of residence Monday - Friday. The Appeals Nurse Consultant position is responsible for processing the medical necessity ... of Medicare appeals for participating providers. Primary duties may include, but are not limited to: Requesting clinical, research, extrapolating pertinent clinical,… more
