Talent.com
Licensed RN Clinical Appeals Reviewer

Licensed RN Clinical Appeals Reviewer

VirtualVocationsDorchester, Massachusetts, United States
job_description.job_card.1_day_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 • Dorchester, Massachusetts, United States

Job_description.internal_linking.related_jobs
  • serp_jobs.job_card.promoted
Clinician

Clinician

Spectrum Health Systems, IncHaverhill, MA, United States
serp_jobs.job_card.full_time
Outpatient Treatment Program - Haverhill, MA.Masters), $69,400-$73,800 (LADC-1), $77,100-$88,100 (LMHC / LICSW).Ranges are dependent upon both licensure & experience. Additional opportunities for prod...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Health Navigator, Sexual Health

Health Navigator, Sexual Health

Fenway HealthBoston, MA, United States
serp_jobs.job_card.full_time
Reporting to the Sexual Health Program Manager, the Health Navigator provides outreach, risk-reduction counseling and HIV / Hepatitis C / STI screening services, check-in, and linkage to care services ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Patient Access Associate - Per Diem

Patient Access Associate - Per Diem

Emerson HospitalConcord, MA, United States
serp_jobs.job_card.full_time
Patient Access Associate - Per Diem.Emerson Hospital, 133 Old Road to Nine Acre Corner, Concord, MA 01742 .Reporting to theSupervisor of Patient Access, this position facilitates th...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Clinical Office Coordinator - Interventional Radiology

Clinical Office Coordinator - Interventional Radiology

Emerson HospitalConcord, MA, United States
serp_jobs.job_card.full_time
Clinical Office Coordinator - Interventional Radiology.Clerical & Administrative Support.Emerson Hospital, 133 Old Road to Nine Acre Corner, Concord, MA 01742 .Reporting to the Seni...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Clinical Intake Counselor

Clinical Intake Counselor

BayMark Health Services CareersBoston, Massachusetts, US
serp_jobs.job_card.full_time
Compassionate Substance Use Counselor Needed!.Don't miss out on this opportunity to grow your career and enjoy.Substance use counselor will be in charge of assisting patients through medically assi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Cancer Registrar

Cancer Registrar

Emerson HospitalConcord, MA, United States
serp_jobs.job_card.full_time
Clerical & Administrative Support.Emerson Hospital, 133 Old Road to Nine Acre Corner, Concord, MA 01742 .Reporting directly to the Cancer Services Manager, interacting with physicia...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Medical Bill Navigator

Medical Bill Navigator

Zelis Healthcare, LLCBoston, MA, United States
serp_jobs.job_card.full_time
Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers.We serve more than 750 payers, including the top five national health plans, regional hea...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
MRI Specialist

MRI Specialist

Yale New Haven HealthNorth Providence, RI, US
serp_jobs.job_card.full_time
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, account...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Senior Clinician - Licensed

Senior Clinician - Licensed

Spectrum Health Systems, IncBridgewater, MA, United States
serp_jobs.job_card.full_time
Bridgewater, MA - Bridgewater State Hospital.Health, dental, vision insurance.Discounts on wide array of services / entertainment. Program Directoris responsible for : .The clinical / educational operatio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Certified Medical Assistant (CMA)

Certified Medical Assistant (CMA)

All Medical AlliedPlymouth, MA, US
serp_jobs.job_card.full_time
We are hiring an experience CMA who is knowledgeable, and compassionate towards patients.We are searching for a reliable candidate with a great work history. Schedule- Mon-Friday 8am-5pm with rotati...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
R & D Patient Engagement Country Lead

R & D Patient Engagement Country Lead

SanofiCAMBRIDGE, MA, United States
serp_jobs.job_card.full_time
R & D Patient Engagement Country Lead.Are you ready to shape the future of medicine? The race is on to speed up drug discovery and development to find answers for patients and their families.Your s...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Utilization Review Coordinator

Utilization Review Coordinator

Universal Health Services, Inc.Brookline, MA, United States
serp_jobs.job_card.full_time
Utilization Review Coordinator Opportunity -.HRI Hospital is seeking a Full-time Utilization Review Coordinator to join our skilled and dedicated team of psychiatric professionals, who provide serv...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Clinical Office Coordinator - Urology

Clinical Office Coordinator - Urology

Emerson HospitalConcord, MA, United States
serp_jobs.job_card.part_time
Clinical Office Coordinator - Urology.Clerical & Administrative Support.ORNAC, Concord, MA, 133 ORNAC, Concord, MA 01742 . Reporting to the Practice Manager and overseen by the offic...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
R & D Patient Engagement, Country Lead

R & D Patient Engagement, Country Lead

SanofiCambridge, MA, US
serp_jobs.job_card.full_time
R & D Patient Engagement, Country Lead.Are you ready to shape the future of medicine? The race is on to speed up drug discovery and development to find answers for patients and their families.Your ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
R & D Patient Engagement Country Lead (Hiring Immediately)

R & D Patient Engagement Country Lead (Hiring Immediately)

SanofiCambridge, Massachusetts, US
serp_jobs.job_card.permanent
R & D Patient Engagement Country Lead.Are you ready to shape the future of medicine? The race is on to speed up drug discovery and development to find answers for patients and their families.Yo...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Patient Access Specialist - Part-Time

Patient Access Specialist - Part-Time

Ensemble Health PartnersNashua, NH, US
serp_jobs.job_card.part_time
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups.They offer end-to-end...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Clinical Office Coordinator - Emerson Cardiovascular Associates

Clinical Office Coordinator - Emerson Cardiovascular Associates

Emerson HospitalConcord, MA, United States
serp_jobs.job_card.part_time
Clinical Office Coordinator - Emerson Cardiovascular Associates.Clerical & Administrative Support.Emerson Hospital, 133 Old Road to Nine Acre Corner, Concord, MA 01742 .Reporting to...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
eBilling Coordinator

eBilling Coordinator

Liberty Personnel Services, Inc.Boston, Massachusetts, US
serp_jobs.job_card.full_time
A nationally recognized law firm with 500+ attorneys providing comprehensive legal services to innovative companies from startups to global enterprises. A variety of soft skills and experience may b...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Patient Access Specialist - Part-time

Patient Access Specialist - Part-time

Ensemble Health PartnersNashua, NH, US
serp_jobs.job_card.part_time
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups.They offer end-to-end...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Health Benefits Attorney (Hybrid $90K - $120K)

Health Benefits Attorney (Hybrid $90K - $120K)

The Phia GroupCanton, MA, US
serp_jobs.job_card.full_time
The Phia Group, LLC is a thriving, service-oriented company headquartered in Canton, Massachusetts.As consultants, we represent health plans nationwide, providing our clients with innovative cost-c...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days