Talent.com
State Licensed Senior Clinical Appeals RN
State Licensed Senior Clinical Appeals RNVirtualVocations • Tamarac, Florida, United States
serp_jobs.error_messages.no_longer_accepting
State Licensed Senior Clinical Appeals RN

State Licensed Senior Clinical Appeals RN

VirtualVocations • Tamarac, Florida, United States
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

A company is looking for a Senior Clinical Appeals RN.

Key Responsibilities

Analyze and respond to DRG appeals, including complex conceptual analyses

Review medical records and collaborate with auditors to determine overpayment or claim adjustments

Prepare written appeals and provide coaching to remote DRG Validation Specialists

Required Qualifications

Associate's degree (or higher)

Unrestricted RN license in the state of residence

3+ years of MS DRG / APR DRG coding experience in a hospital environment

Advanced proficiency with ICD-10-CM and ICD-10-PCS coding

CCS or CIC certification or ability to obtain within 6 months of hire

serp_jobs.job_alerts.create_a_job

Licensed Clinical • Tamarac, Florida, United States

Job_description.internal_linking.related_jobs
State Licensed Patient Care Director

State Licensed Patient Care Director

VirtualVocations • Boca Raton, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Director, Patient Care to lead and evolve their Care Navigation and Clinical teams.Key Responsibilities Lead and develop a high-performing Patient Care organization Es...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Tennessee Licensed Clinical Documentation Specialist

Tennessee Licensed Clinical Documentation Specialist

VirtualVocations • Boca Raton, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Clinical Documentation Specialist (RN required) (CCDS or CDIP cert preferred) - REMOTE. Key Responsibilities Performs assessment of patient records to evaluate do...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
CRNA - Anesthesiology job available in Loxahatchee, Florida

CRNA - Anesthesiology job available in Loxahatchee, Florida

Envision Physician Services • Loxahatchee Groves, FL, US
serp_jobs.job_card.full_time
Envision Physician Services and HCA Florida Palms West Surgicenter are currently seeking full-time CRNAs in Loxahatchee, Florida in beautiful Palm Beach County. Lucrative Compensation Package and 75...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Oregon Licensed Clinical Review Nurse

Oregon Licensed Clinical Review Nurse

VirtualVocations • Hollywood, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Nurse - Prior Authorization.Key Responsibilities Review both prior authorization (PA) and inpatient (IP) requests Complete up to 20 authorization revie...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
State Licensed Clinical Analyst

State Licensed Clinical Analyst

VirtualVocations • Pompano Beach, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Clinical Analyst to combine clinical data expertise with relationship management to ensure accurate claims processing and optimize carrier performance.Key Responsi...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Washington State Licensed Case Manager

Washington State Licensed Case Manager

VirtualVocations • Davie, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Case Manager.Key Responsibilities Engage target members facing medical, mental health, and substance utilization disorders to build supportive relationships Conduct in...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Oregon Licensed Clinical Appeals Coordinator

Oregon Licensed Clinical Appeals Coordinator

VirtualVocations • Boca Raton, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Appeals Coordinator.Key Responsibilities Act as a liaison for statewide appeals and ensure compliance with State and NCQA requirements Review clinical informa...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
State Licensed Clinical Audit Lead

State Licensed Clinical Audit Lead

VirtualVocations • Davie, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Audit Lead.Key Responsibilities Supervises teams to ensure compliance with laws, regulations, and organizational policies Implements measures to mitigate risk...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
California Licensed Clinical Case Manager

California Licensed Clinical Case Manager

VirtualVocations • Hollywood, Florida, United States
serp_jobs.job_card.full_time
A company is looking for an Out of Network (OON) Clinical Case Manager (CM) - Remote (CA Only) - Per diem - Variable.Key Responsibilities Coordinate quality healthcare services in out of network ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
California Licensed Clinical Case Consultant

California Licensed Clinical Case Consultant

VirtualVocations • Davie, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Registered Nurse - Clinical Case Consultant (CalAIM ECM Program).Key Responsibilities Provide clinical oversight and guidance to care coordinators and case managers, en...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Oregon Licensed Clinical Supervisor

Oregon Licensed Clinical Supervisor

VirtualVocations • Hollywood, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Supervisor - OR - LPC or LCSW - Remote.Key Responsibilities Provide supervision to a minimum of six resident clinicians, including weekly group and individual ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
State Licensed Associate Medical Director

State Licensed Associate Medical Director

VirtualVocations • Hialeah, Florida, United States
serp_jobs.job_card.full_time
A company is looking for an Associate Medical Director - PRN (Remote U.Key Responsibilities Oversee clinical decision-making aspects of the Utilization Management program Collaborate with Region...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
State Licensed Clinical Reviewer

State Licensed Clinical Reviewer

VirtualVocations • Davie, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Reviewer to perform Utilization Management and review clinical information for service requests. Key Responsibilities Evaluate referral appropriateness for serv...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Florida Licensed Clinical Specialist

Florida Licensed Clinical Specialist

VirtualVocations • Davie, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Specialist to join their remote team.Key Responsibilities Utilize motivational interviewing techniques to engage patients in services Complete necessary docum...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
State Licensed Clinical Content Manager

State Licensed Clinical Content Manager

VirtualVocations • Hollywood, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Content Manager to lead the strategy and development of clinical content across various formats. Key Responsibilities Create high-quality clinical content for m...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Illinois Licensed RN Case Manager

Illinois Licensed RN Case Manager

VirtualVocations • Hialeah, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Field RN Case Manager.Key Responsibilities Manage care for patients in a remote setting, ensuring effective communication and coordination Conduct discharge planning a...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Arizona Licensed Clinical Review Nurse

Arizona Licensed Clinical Review Nurse

VirtualVocations • Hollywood, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Performs concurrent reviews to determine overall health and appropriate level of care for members Review...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Remote Clinical Claim Review RN

Remote Clinical Claim Review RN

VirtualVocations • Davie, Florida, United States
serp_jobs.filters.remote
serp_jobs.job_card.full_time
Key Responsibilities Conduct MS-DRG and APR-DRG coding reviews to verify accuracy and identify overpayments Perform clinical coding reviews ensuring accuracy and compliance with coding guideline...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Georgia Licensed Clinical Policy Manager

Georgia Licensed Clinical Policy Manager

VirtualVocations • Hollywood, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Manager, Clinical Policy to join their Clinical Policy team.Key Responsibilities Evaluate vendor policy sets for compliance with internal and external medical standards...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
State Licensed Director of Clinical Excellence

State Licensed Director of Clinical Excellence

VirtualVocations • Davie, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Director, Clinical Excellence (Post Acute, VBC).Key Responsibilities Lead the operational delivery of the post-acute care program to ensure coordinated patient transiti...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted