A company is looking for a Clinical Appeals Specialist RN (Remote).Key ResponsibilitiesCoordinate the Medicaid and Non-Medicaid denial and appeals processesPrepare clinical documentation and represent the organization in mediation and appeals hearingsMaintain accurate records and assist in data collection and reporting related to appealsRequired Qualifications, Training, and EducationBachelor's degree in Nursing with active RN licensure in North CarolinaTwo years of post-degree professional experienceKnowledge of integrated health and managed care preferredExperience in utilization management and claims processing conceptsProficiency in Microsoft Office Suite and relevant reporting systems
Clinical Appeals Specialist RN
A company is looking for a Clinical Appeals Specialist RN (Remote). ...
Clinical Documentation Specialist RN
A company is looking for a Clinical Documentation Specialist RN for a remote position in Aurora, Colorado. ...
RN Clinical Documentation Specialist
A company is looking for a Clinical Documentation Specialist to perform chart reviews for Medicare patients. ...
Travel Registered Nurse - ER/Trauma in Snellville, GA - Excellent Benefits 2024-10-27
TravelNurseSource is working with Trustaff to find a qualified ER/Trauma RN in Snellville, Georgia, 30039!. ER nurses must be able to recognize and effectively treat life-threatening conditions, so be ready to work as part of a close-knit team in a fast-paced environment. Travel nurses work for a li...
Travel Nurse - RN - Case Manager - $2600 / Week - Hiring Now
Medical Talent is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in Marietta, GA. ...
Bilingual Spanish RN Case Manager
A company is looking for a Bilingual Spanish Telehealth RN Case Manager, SNP with a California RN License. Key Responsibilities:Coordinate care for patients, families, and physiciansAssess and develop care plans for members with complex and chronic care needsMonitor and evaluate the effectiveness of...
Utilization Review Nurse
By continuously reviewing and auditing member treatment records, the utilization review nurse will ensure members do not receive unnecessary procedures, ineffective treatment, or experience unnecessarily extensive hospital stays. The Utilization Review Nurse’s role is to ensure that health car...
Hospice (RN) Case Manager
Hospice (RN) Case Manager Opportunity in Marietta, GA. Titan Placement Group is currently seeking a compassionate and experienced Hospice RN Case Manager to join a reputable healthcare team in Marietta, GA, a charming city located in the Atlanta metropolitan area known for its historic neighborhoods...
RN, Inpatient Case Manager - ED, Fulltime (Night - Weekend), Emory Saint Josephs
The activities will include daily review of hospital care by chart review and discussion with attending physician, admission and concurrent review for inpatient admissions, meetings with patient and families to develop discharge planning, identification of patients for ambulatory case management, co...
Utilization Review Nurse
What You'll Do* Review and analyze medical records to assess the appropriateness and necessity of healthcare services* Ensure compliance with established clinical guidelines, policies, and regulatory requirements* Collaborate with healthcare providers to gather additional information when needed* Ut...