Pennsylvania Licensed Clinical Appeals Reviewer
VirtualVocationsLas Vegas, Nevada, 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 a Clinical Appeals Reviewer.
Key Responsibilities
Process appeals while ensuring compliance with regulatory milestones
Review medical records for documentation and billing code compliance
Engage with appellants, providers, and members to gather necessary information for case determination
Required Qualifications, Training, and Education
Bachelor's degree (BSN) required
3 or more years of experience in a related clinical setting
Current and unrestricted Registered Nurse (RN) licensure
Working knowledge of InterQual criteria preferred
Proficiency in utilizing Electronic Medical Records (EMRs) and MS Office
serp_jobs.job_alerts.create_a_job
Clinical Reviewer • Las Vegas, Nevada, United States
Job_description.internal_linking.related_jobs A company is looking for a Claims Examiner, Medical Only.Key Responsibilities Investigate workers' compensation claims for medical care without lost wages Approve medical treatments, schedule ap...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_variable_hours A company is looking for a Staff Counsel II.Key Responsibilities Independently represents the Insured in court and presents witnesses and evidence on litigated claims Analyzes complex legal issu...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day 
Confidential Opportunity – Commercial Litigation Associate (2–5+ Years).Commercial Litigation (Defense).A highly respected national law firm with a strong presence across all 50 states ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a Stop Loss Filing Coordinator to manage the end-to-end stop loss claims process.Key Responsibilities : Prepare and submit stop-loss claims and supporting documentation A...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours A company is looking for a Workers Compensation Claims Examiner III (Temporary).Key Responsibilities Manage a caseload of 150 to 180 workers' compensation files, including complex claims Conduct...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Senior Workers Compensation Claims Adjuster.Key Responsibilities Execute decision-making to analyze and resolve claims while managing claims exposure Interact with var...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Claims Analyst to join their team in a remote capacity.Key Responsibilities Provide exceptional resolution of claim files to ensure a best-in-class claims experience I...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours 
Job Description : The position we are hiring for is customer / client relations.In this position you will be writing claims and submitting the paperwork.
Duties can be performed remotely.Company Inform...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Claims Specialist (PAWP).Key Responsibilities Adjust claims for assigned PAWP programs Build and maintain relationships with internal and external customers Investiga...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 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 Senior Claims Examiner to adjudicate complex life insurance claims.Key Responsibilities Lead the adjudication of complex or contested life insurance claims Conduct tho...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours 
A rapidly growing litigation law firm focused on plaintiff's side labor and employment law is seeking an Employment Litigation Associate.
The firm consists of personable, published, and well-kno...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a Regulatory Counsel to join their legal team remotely.Key Responsibilities Research, interpret, and summarize state-specific regulations related to litigation support D...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 
Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc.
Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 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 Chief Counsel for the Arc Blockchain Network.Key Responsibilities Advise on the design, launch, and governance of the Arc Network to ensure legal and regulatory complia...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Workers' Compensation Claims Adjuster to manage complex claims in various jurisdictions across the United States.
Key Responsibilities Adjudicate higher complexity worke...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours 
Hooks Meng & Clement (HMC) is looking for an Associate Attorney to join our growing Las Vegas office.Our firm specializes in Industrial Litigation, representing a diverse clientele, including e...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 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
- serp_jobs.job_card.promoted
Workers' Compensation Claims Examiner
VirtualVocationsLas Vegas, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Health Claims Examiner
VirtualVocationsHenderson, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
New York Licensed Staff Counsel
VirtualVocationsHenderson, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Litigation Associate Attorney
Aionios LLCLas Vegas, NV, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Stop Loss Claims Coordinator
VirtualVocationsHenderson, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
California Licensed Claims Examiner
VirtualVocationsHenderson, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Michigan Licensed Claims Adjuster
VirtualVocationsHenderson, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Licensed Claims Analyst
VirtualVocationsHenderson, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Remote Claims Writer
Metro Public AdjustmentLas Vegas, NV, USserp_jobs.filters.remote
serp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
California Licensed Claims Specialist
VirtualVocationsLas Vegas, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Medicare Eligibility Representative
VirtualVocationsHenderson, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Senior Claims Examiner
VirtualVocationsLas Vegas, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Litigation Associate (Plaintiff Side)
Goodwin RecruitingLas Vegas, NV, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Regulatory Counsel
VirtualVocationsHenderson, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Workers' Compensation Claims Adjuster
Argonaut Management Services, IncLas Vegas, NV, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
ABA Intake Admin Assistant
VirtualVocationsLas Vegas, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Chief Counsel, Blockchain Network
VirtualVocationsHenderson, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
- serp_jobs.job_card.new
Workers' Compensation Claims Adjuster (FL, RI, TX Licensed)
VirtualVocationsHenderson, Nevada, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Hooks Meng & Clement (Hmc) Is Looking For An Associate Attorney
Hooks Meng & ClementLas Vegas, NV, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Remote Medical Insurance Verifier
VirtualVocationsLas Vegas, Nevada, United Statesserp_jobs.filters.remote
serp_jobs.job_card.full_time