Talent.com
California Licensed Clinical Appeals RN

California Licensed Clinical Appeals RN

VirtualVocationsHenderson, Nevada, United States
job_description.job_card.30_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 Clinical Appeals RN - Fully Remote.

Key Responsibilities

Review medical records to verify service criteria and clinical eligibility for coverage

Coordinate reviews with the Medical Director and document determinations accurately

Adhere to confidentiality regulations while interpreting Plan language

Required Qualifications

Active, unrestricted RN license in state of residence

2+ years of clinical experience as an RN in an acute, inpatient hospital setting

Proficiency in Microsoft Office, including Word and Outlook

Availability for 5-day work weeks, including weekdays and alternating weekends

serp_jobs.job_alerts.create_a_job

Clinical California • Henderson, Nevada, United States

Job_description.internal_linking.related_jobs
  • serp_jobs.job_card.promoted
Texas Licensed Clinical Appeals Coordinator

Texas Licensed Clinical Appeals Coordinator

VirtualVocationsHenderson, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Appeals Coordinator.Key Responsibilities Act as the liaison for statewide appeals, ensuring compliance with State and NCQA requirements Review clinical inform...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
California Licensed Concurrent Review Nurse

California Licensed Concurrent Review Nurse

VirtualVocationsHenderson, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Concurrent Review Nurse (RN) (Temporary).Key Responsibilities Performs concurrent, post-service, and retrospective reviews of acute in-patient care services using estab...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Travel CT Tech - $2,620 to $2,928 per week in Hackensack, CT

Travel CT Tech - $2,620 to $2,928 per week in Hackensack, CT

AlliedTravelCareersHackensack, CT, US
serp_jobs.job_card.full_time
AlliedTravelCareers is working with Prime Time Healthcare to find a qualified CT Tech in Hackensack, Connecticut!.Now Hiring : Allied Healthcare CT - Hackensack, NJ. Contact us for Pay Information.Ac...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
North Carolina Licensed Case Manager

North Carolina Licensed Case Manager

VirtualVocationsHenderson, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Remote Case Manager.Key Responsibilities Collaborate with a multidisciplinary healthcare team to monitor utilization patterns and facilitate appropriate care delivery ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Alabama Licensed Medical Reviewer

Alabama Licensed Medical Reviewer

VirtualVocationsLas Vegas, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Medical Reviewer II to perform medical reviews and support medical claims.Key Responsibilities Conducts medical claim reviews and determines medical necessity based on ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Travel Licensed Clinical Social Worker (LCSW) - $1,500 to $1,663 per week in Las Vegas, NV

Travel Licensed Clinical Social Worker (LCSW) - $1,500 to $1,663 per week in Las Vegas, NV

AlliedTravelCareersHenderson, Nevada, US
serp_jobs.job_card.full_time
AlliedTravelCareers is working with LRS Healthcare to find a qualified Licensed Clinical Social Worker in Las Vegas, Nevada, 89119!. Ready to start your next travel adventure? LRS Healthcare offers ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
New York Licensed Clinical Appeals Specialist

New York Licensed Clinical Appeals Specialist

VirtualVocationsNorth Las Vegas, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Denials & Appeals Specialist (Remote).Key Responsibilities Review and respond to Corporate Compliance Audits and denial trends Prepare and defend level of car...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
California Licensed Clinical Informatics Specialist

California Licensed Clinical Informatics Specialist

VirtualVocationsHenderson, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Informatics Specialist (Virtual).Key Responsibilities Support clinicians and caregivers in the utilization of Epic and other clinical technologies Act as a li...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
State Licensed Appeals Nurse Consultant

State Licensed Appeals Nurse Consultant

VirtualVocationsHenderson, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Utilization Management Appeals Nurse Consultant (Remote).Key Responsibilities Administers review and resolution of clinical complaints and appeals Interprets data from...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Texas Licensed RN Case Manager

Texas Licensed RN Case Manager

VirtualVocationsHenderson, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Case Manager RN.Key Responsibilities Assess member health status and coordinate care needs, including inpatient review and discharge planning Develop and implement tre...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
California Licensed NP / PA Contractor

California Licensed NP / PA Contractor

VirtualVocationsNorth Las Vegas, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Research NP / PA Contractor.Key Responsibilities Administer cSLEDAI-2K and cPGA assessments via secure video call, adhering to study protocols Document assessment result...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Texas Licensed Case Manager RN

Texas Licensed Case Manager RN

VirtualVocationsHenderson, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Registered Nurse II - Case Manager.Key Responsibilities Manage continuity of care for beneficiaries through comprehensive assessments and care planning Coordinate foll...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
California Licensed Health Plans Auditor

California Licensed Health Plans Auditor

VirtualVocationsHenderson, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Specialty Health Plans Auditor III, Claims.Key Responsibilities Lead planning, execution, reporting, and corrective action monitoring for claims processing compliance a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_hour
  • serp_jobs.job_card.promoted
California Licensed Telehealth Nurse Manager

California Licensed Telehealth Nurse Manager

VirtualVocationsHenderson, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Telehealth Nurse Practitioner Manager to lead and support a team of remote Family Nurse Practitioners providing virtual consultations. Key Responsibilities Lead, mentor,...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Tennessee Licensed Appeals Coordinator

Tennessee Licensed Appeals Coordinator

VirtualVocationsHenderson, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for an Appeals and Letters Coordinator remote position.Key Responsibilities : Process denial-related and member-oriented written communications in compliance with Federal and ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
California Licensed DRG QA Trainer

California Licensed DRG QA Trainer

VirtualVocationsLas Vegas, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a DRG QA and Trainer.Key Responsibilities Oversee quality assurance of DRG Reviewers, ensuring compliance with clinical and coding standards Conduct training sessions fo...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
California Licensed Clinical Applications Professional

California Licensed Clinical Applications Professional

VirtualVocationsHenderson, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Applications Professional 4 - Ambulatory.Key Responsibilities Lead the development, upgrade, enhancement, and support of Clinical Information systems Manage l...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
California Licensed Triage Nurse RN

California Licensed Triage Nurse RN

VirtualVocationsLas Vegas, Nevada, United States
serp_jobs.job_card.full_time
A company is looking for a Triage Nurse RN (Telehealth) for a part-time weekend position.Key Responsibilities Receive inbound and place outbound calls to patients for clinical assessment and tria...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days