Jobs: greviece and appeals nurse

Job Description Summary: Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical necessity and/or level of care. This associate will be a liaison and point of contact for clinical denials and appeal inquiries. The Clinical...

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 considered a production role and remains as part of the Nurse Appeal Consultant job cod Appeals, Nurse, Consultant, Remote, Health, Technology, Retail, Benefits

Conducts investigations and reviews of member and provider medical necessity appeals. Reviews prospective, inpatient, or retrospective medical records of denied services for medical necessity. Extrapolates and summarizes medical information for medic Appeals, Nurse, Medical Director, Skills, Healthcare, Compensation, Benefits

This position will be working from home anywhere in the US. Standard business hours 8 a-5 p in time zone of residence Monday - Friday. The Appeals Nurse Consultant position is responsible for processing the medical necessity of Medicare appeals for p Appeals, Nurse, Consultant, Remote, Technology, Retail

This position will be working from home anywhere in the US. Standard business hours 8 a-5 p in time zone of residence Monday - Friday. The Appeals Nurse Consultant position is responsible for processing the medical necessity of Medicare appeals for p Appeals, Nurse, Consultant, Remote, Technology, Retail

Job Title: Grievance and Appeals Nurse SpecialistCalOptima Health is seeking a highly motivated an experienced TEMP - Grievance & Appeals Nurse Specialist to join our team.The Grievance and Appeals Nurse Specialist participates in managing CalOptima Healths medical appeals and state hearing reviews for all lines of business, including handling expedited...

Job Title: Grievance and Appeals Nurse SpecialistCalOptima Health is seeking a highly motivated an experienced TEMP - Grievance & Appeals Nurse Specialist to join our team.The Grievance and Appeals Nurse Specialist participates in managing CalOptima Healths medical appeals and state hearing reviews for all lines of business, including handling expedited...

Nurse Appeals- California candidates only Location:This is a virtual position and prefer candidates reside within 50 miles of an Elevance Health PulsePoint location. Schedule:Monday - Friday 8:00 am to 4:30 pm PST Saturdays and Holidays required How you will make an impact: Responsible for investigating and processing and medical necessity appeals requests...

Job DescriptionJob DescriptionLVN RANGE $38.91-$55.62RN RANGE $50-$85Job Description: Conduct and investigate member and provider medical necessity appealsReview prospective, inpatient, and retrospective medical records of denied services for medical necessityEnsures appeals and grievances are resolved in a timely mannerPrepare clinical reviews and provides...

Job Description - Appeals & Grievances Coordinator (3285818) Appeals & Grievances Coordinator ( Job Number: 3285818 ) While a remote role, this team meets every other month at the office at Assembly Row in Somerville and attendance is highly encouraged. This role would also require on-call coverage on the weekends (currently every third weekend...

Job Family: MED > Licensed Nurse - Type: Full time - Date Posted: Apr 24, 2024 - Anticipated End Date: May 01, 2024 - Reference: JR112445 **Description**: **Nurse Appeals **Schedule: Monday**: - Friday 8:00 am to 4:30 pm PST Saturdays and Holidays required** The **Nurse Appeals **is responsible for investigating and processing and medical necessity...

Summary: Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical necessity and/or level of care. This associate will be a liaison and point of contact for clinical denials and appeal inquiries. The Clinical Appeals Nurse will review...

Job DescriptionSummary:Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical necessity and/or level of care. This associate will be a liaison and point of contact for clinical denials and appeal inquiries. The Clinical Appeals Nurse...

Job Description Summary: Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical necessity and/or level of care. This associate will be a liaison and point of contact for clinical denials and appeal inquiries. The Clinical Appeals...

DescriptionSummary: Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical necessity and/or level of care. This associate will be a liaison and point of contact for clinical denials and appeal inquiries. The Clinical Appeals Nurse...

DescriptionSummary: Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical necessity and/or level of care. This associate will be a liaison and point of contact for clinical denials and appeal inquiries. The Clinical Appeals Nurse...

Job TypeFull-timeDescriptionThe Appeals and Denials Specialist is responsible for triaging and writing DRG downgrades and clinical validation appeal letters for multiple clients. The Appeals and Denials Specialist will ensure appropriate action is taken within appeal deadlines. This position collaborates with the Appeals and Denials team and other...

All Jobs > Appeals and Denials Specialist The Appeals and Denials Specialist is responsible for triaging and writing DRG downgrades and clinical validation appeal letters for multiple clients. The Appeals and Denials Specialist will ensure appropriate action is taken within appeal deadlines. This position collaborates with the Appeals and Denials team and...

Job Type Full-time Description The Appeals and Denials Specialist is responsible for triaging and writing DRG downgrades and clinical validation appeal letters for multiple clients. The Appeals and Denials Specialist will ensure appropriate action is taken within appeal deadlines. This position collaborates with the Appeals and Denials team and other...

Job Type Full-time Description The Appeals and Denials Specialist is responsible for triaging and writing DRG downgrades and clinical validation appeal letters for multiple clients. The Appeals and Denials Specialist will ensure appropriate action is taken within appeal deadlines. This position collaborates with the Appeals...