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
Appeals and Grievances Clinical Specialist - RN or LPN
A company is looking for an Appeals and Grievances Clinical Specialist - RN or LPN, 100% Remote. ...
Clinical Appeals Specialist
A company is looking for a Clinical Appeals Specialist to support their product launch in the Appeal Writing space. ...
RN Clinical Documentation Specialist
A company is looking for a Clinical Documentation Specialist to perform chart reviews for Medicare patients. ...
RN, Inpatient Case Manager, On-Call, 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...
Travel Registered Nurse - ER/Trauma - $1,563 per week in Fayetteville, GA
TravelNurseSource is working with Amare Medical Network to find a qualified ER/Trauma RN in Fayetteville, Georgia, 30214!. Emergency Room Nurses (RN) are responsible to treat a variety of injuries and illness brought into the Emergency Room. An Emergency Room Nurse must take measures to stabilize a ...
Travel Nurse - RN - Case Manager - $2600 / Week
Medical Talent is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in Marietta, GA. ...
Registered Nurse-RN-Acute Care- Surgical Unit - Nights - MedSurg
It is expected that all RN Clinical Nurses are licensed, knowledgeable and uphold the practice of nursing as outlined by the Georgia Professional Nurse Practice Act and implements the Scope of Practice and Code of Ethics Standards put forth by the American Nurses Association. Facility: Cobb Hospital...
Clinical Review Nurse - Appeals
A company is looking for a Clinical Review Clinician - Appeals (RN). ...
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...
Dialysis Registered Nurse (RN)
Ansible Government Solutions, LLC (Ansible) is currently recruiting multiple Dialysis Registered Nurses to support the Atlanta VA Health Care Center located at 1670 Clairmont Rd, Decatur, GA 30033. Completion of an accredited Registered Nurse academic program (BSN or ADN). Current Registered Nurse l...