CLINICAL APPEALS SPECIALIST RN jobs in UNITED STATES, United Kingdom

in the United States for this remote role.) Xtend Healthcare is looking for aClinical Appeals Specialist, RN who... on both the provider and payor side. Must be an RN, with clinical knowledge of documentation requirements for payment...

and appeals in a manner that diligently investigates every unpaid claim Assesses the need for formal appeals of all clinical... clinical documentation to ensure its sufficiency Utilizes various resources in order to understand the appeals and denials...

The Customer Solution Center Appeals and Grievances Nurse Specialist LVN II is primarily responsible for the overall... of the A&G Nurse Specialist, RN and/or Medical Director. This position provides assistance to members with health care access...

to others within the RCO, clinical departments, Appeal RN’s, legal, IPAS and Payor Contracting on the art of appealing. 8. Works closely... Manager of Appeals. This role is fully remote and works a schedule of Monday - Friday with flexible hours between 6am - 6pm...

in our mission Reviews provider appeals and redeterminations using approved clinical and coding guidelines... looking for Unrestricted RN license or Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Medical...

in our mission Reviews provider appeals and redeterminations using approved clinical and coding guidelines... looking for Unrestricted RN license or Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Medical...

must complete several pre-employment requirements prior to starting. to learn more! RN - Clinical Coding Specialist FINANCE... . The Clinical Coding Specialist RN will play a clinical role in the coding department. Responsibilities will include...

all clinical documentation regulatory guidelines Formulates and submits timely, well prepared appeals for reconsideration by third... them to challenge the status quo, we know they will be the difference The Opportunity: The CDI Specialist facilitates...

System. Nature and Scope The RN Clinical Review Specialist will: Conduct review of clinical-based denials... of supporting clinical evidence of appropriate, medically necessary care to payors in the form of written appeals. Provide...

Clinical Denial Specialist writes and submits professionally written appeals which include compelling arguments based... Date of Hire Same Day Pay through Daily Pay Clinical DRG Denials Specialist The Clinical Coding Denial Specialist...

Responsibilities Processes, tracks and appeals clinical denials. Supports and facilitates the design, development... Management * Graduate of an accredited school of nursing, with strong clinical case management experience Three (3) years...

Clinical Documentation Specialist *This position is onsite at Day Kimball Healthcare in Putnam, CT and candidate... for this position is through ENSEMBLE* Job Summary: The CDI Specialist facilitates and obtains appropriate physician documentation...

appeals for reconsideration by third party administrators (payors). Including supporting documented clinical evidence, Coding... Kimball Healthcare in Putnam, CT and candidate must be able to work FT onsite at this location* The CDI Specialist...

all clinical documentation regulatory guidelines Formulates and submits timely, well prepared appeals for reconsideration by third... and candidates must be able to work onsite at NCH - North Hospital in Naples, FL 2 days per week.* The CDI Specialist facilitates...

for better? Job Description The RN Utilization Specialist reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics... and accreditation standards. The RN Utilization Specialist (RNUS) is an experienced registered professional nurse with extensive...

Email Submit RN Utilization Specialist-Utilization Review Full Time Days Location Palos Heights, Illinois Business Unit Palos.... Description The RN Utilization Specialist reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics...

Email Submit RN Utilization Specialist-Utilization Review Full Time Days Location Palos Heights, Illinois Business Unit Palos.... Description The RN Utilization Specialist reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics...