Licensed RN Clinical Appeals Reviewer
VirtualVocationsWichita, Kansas, United Statesjob_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for an IBR Clinical Appeals Reviewer who will analyze and respond to client and hospital claim review appeal inquiries.
Key Responsibilities :
Analyze scope and resolution of IBR Appeals and respond to various levels of appeals
Perform complex analyses, identify risk factors, and recommend appropriate actions based on regulations and medical policies
Collaborate with auditors and prepare written appeals while navigating web-based portals and online tools
Required Qualifications :
Undergraduate nursing degree
Unrestricted RN (registered nurse) license
2+ years of appeals experience (coding or auditing)
Experience with CPT-4 coding and advanced knowledge of ICD10 CM and ICD 10 PCS coding
Advanced experience with regulations, compliance, and composing professional appeal responses
serp_jobs.job_alerts.create_a_job
Clinical Reviewer Rn • Wichita, Kansas, United States
Job_description.internal_linking.related_jobs A company is looking for a Medicaid Pending Compliance Assistant.Key Responsibilities : Assist with tracking and maintaining Medicaid Pending reports for assigned Skilled Nursing Facilities Follo...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for an ABA Intake & Authorizations Admin Assistant - Spanish Speaking.Key Responsibilities Facilitate the client onboarding process and ensure accurate documentation and comm...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Patient Experience Representative to provide exceptional support to patients and caregivers in a remote setting.
Key Responsibilities Handle inbound and outbound calls f...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Medicare Enrollment Representative II.Key Responsibilities Maintains accurate eligibility records for individuals and employer groups Processes enrollments, plan chang...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Risk Adjustment Medical Record Scheduling & Imaging Technician.Key Responsibilities Load medical records into the coding system and link to appropriate chart IDs Sched...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Patient Screening Specialist to efficiently screen, schedule, and guide patients through the clinical trial process.
Key Responsibilities Conduct phone screenings to ass...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for an Enrollment - Eligibility Representative.Key Responsibilities Research benefits, eligibility, and site of care for Medicare Part B members Communicate with doctor's of...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Medical Reviewer / Safety Reviewer III.Key Responsibilities Provide medical oversight for scientific review and approval of promotional and medical materials Collaborate...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Health Information Specialist I - OnBase Indexer.Key Responsibilities : Perform chart processing functions including preparation, scanning, indexing, and quality review ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Utilization Review Specialist to monitor and ensure the effective use of outpatient services.Key Responsibilities Establish and maintain methods for ensuring medical ne...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Medical Coder III with Cardiology experience.Key Responsibilities Review and submit 64 encounters per day related to various cardiology services Maintain coding knowle...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for an IBR Clinical Appeals Reviewer - Remote.Key Responsibilities Analyze and respond to IBR Appeals inquiries Perform medical record reviews and prepare written appeals C...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Medical Bite Question Writer (USMLE Step 1 & Step 2).Key Responsibilities Produce high-yield recall questions and explanations based on medical science subjects Collab...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Health Information Discharge Analyst I.Key Responsibilities Reviews inpatient records to ensure completion of discharge summaries and identifies deficiencies Updates d...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Clinical Appeals Reviewer.Key Responsibilities Process appeals while ensuring compliance with regulatory milestones Review medical records for documentation and billin...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Clinical Document Specialist for a full-time remote position.Key Responsibilities Utilize clinical, coding, and Clinical Documentation Integrity (CDI) knowledge to enha...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Healthcare Credentialing Coordinator, part-time and remote.Key Responsibilities Manage the credentialing and re-credentialing process for healthcare providers, ensuring...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Health Claims Examiner I.Key Responsibilities Review medical documents to ensure completeness and validity for claim adjudication Determine covered services and calcul...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_hour A company is looking for a Remote Medical Insurance Verification Specialist.Key Responsibilities Assist patients with obtaining coverage for prescription medications Make inbound / outbound calls ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Physician Reviewer - Utilization Review.Key Responsibilities Conduct timely medical reviews to ensure compliance with quality parameters Make clinical determinations b...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
- serp_jobs.job_card.promoted
Medicaid Compliance Assistant
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
ABA Intake Admin Assistant
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Patient Experience Representative
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Medicare Enrollment Representative
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Medical Record Technician
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Patient Screening Specialist
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Medicare Eligibility Representative
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Medical Reviewer Contractor
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Health Information Specialist I
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Texas Licensed Utilization Review Specialist
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Certified Medical Coder III
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
RN Clinical Appeals Reviewer
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Medical Question Writer
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Health Information Analyst
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Pennsylvania Licensed Clinical Appeals Reviewer
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Michigan Licensed Clinical Document Specialist
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Healthcare Credentialing Coordinator
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Health Claims Examiner
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Remote Medical Insurance Verifier
VirtualVocationsWichita, Kansas, United Statesserp_jobs.filters.remote
serp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Licensed Physician Reviewer
VirtualVocationsWichita, Kansas, United Statesserp_jobs.job_card.full_time