Clinical Appeals Specialist
Part-time, can work remotely
Summary :
The Clinical Appeals Specialist is primarily responsible for analyzing and interpreting hospital and MD medical records and composing a clinical appeal to the insurance company.
Responsibilities :
Compose appeals to dispute insurance adverse determinations related to medical necessity.
Construct 1st and 2nd level appeals by applying clinical rationale.
Manage assigned workload of accounts so that appeals are submitted timely in accordance with payer timeframes.
Maintain strictest confidentiality; adheres to all HIPAA guidelines / regulations.
Required Work Experience :
Clinical background, minimum RN experience
Experience in writing clinical appeals
Hospital experience
Skills :
Strong understanding of basic medical coding
Ability to develop effective working relationships with the facility and payers.
Effective written and verbal communication skills
Strong analytical, organizational, multi task and time management skills
Attention to detail
Clinical Appeals Specialist
The Clinical Appeals Specialist is primarily responsible for analyzing and interpreting hospital and MD medical records and composing a clinical appeal to the insurance company. Construct 1st and 2nd level appeals by applying clinical rationale. Experience in writing clinical appeals. Compose appeal...
Registered Nurse-Acute MedSurgical A-PRN
A professional who utilizes the nursing process to assess, implement, coordinate, and evaluate patient care activities.Collaborate with other Clinical Associates and Healthcare disciplines to meet individual needs using appropriate resources to ensure quality, safe, and cost-effective care.Nurtures ...
staff - Registered Nurse (RN) - Home Health Care Manager - $82K+ per year
LHC Group is seeking a Registered Nurse (RN) Home Health Care Manager for a nursing job in Shreveport, Louisiana. We are hiring for a Registered Nurse (RN) Patient Care Manager - Clinical Manager with Home Health experience. ...
Travel Nurse - Registered Nurse - PCU - Progressive Care Unit - $1638 / Week
Uniti Med is seeking an experienced Progressive Care Unit Registered Nurse for an exciting Travel Nursing job in Shreveport, LA. ...
Travel Nurse RN - Case Manager - $1,799 to $1,995 per week in Slidell, LA
Ready to learn more? Apply today to start your Travel Adventure with LRS Healthcare!. ...
Travel Registered Nurse - Oncology - $1,874 to $2,074 per week in New Orleans, LA
New Orleans, LA, United States .Titan Medical is looking for travelers to fill a Travel Oncology position for a 13 week assignment in New Orleans, LA! Call Titan for additional details....
Travel Nurse RN - Case Manager - $1,799 to $1,995 per week in Slidell, LA
TravelNurseSource is working with LRS Healthcare to find a qualified Case Manager RN in Slidell, Louisiana, 70461!. Ready to learn more? Apply today to start your Travel Adventure with LRS Healthcare!. LRS Healthcare has flexible travel RN jobs nationwide with top facilities. ...
Travel Registered Nurse - PCU - $1,617 per week in Shreveport, LA
But the one thing nurse after nurse has said they want and don't have is someone in their corner. We've talked to thousands of travel nurses like you. You and every nurse with the guts to travel deserve it. ...
Travel Registered Nurse - Telemetry - $1,488 per week in Zachary, LA
GetMed Staffing is searching for a strong Telemetry RN to assist our traveler-friendly client.A minimum of 1-2 years of experience is required.Traveling with GetMed Staffing offers the unique opportunity to gain diverse experiences, both personally and professionally....
Travel Registered Nurse - ER/Trauma - $1,780 per week in Kenner, LA
Advantis Medical, the #1 rated travel nurse agency, is currently seeking an experienced ER/Trauma Registered Nurse (RN) for an exciting new travel job in Kenner, LA 70065. If you are an experienced ER/Trauma Registered Nurse (RN) with a passion for providing exceptional patient care, just let us kno...