in clinical Appeals Review and is an LPN – Required and Preferred. Must maintain a courteous and respectful disposition... with a company behind it. What You’ll Be Doing: The Evolent Appeals Nurse team offers candidates the opportunity to make...
all commercial and government clinical appeals and audit processes. The Clinical Analyst will perform high level clinical appeal.../processes and procedures; to gather information that would support submitted charges. Prepare clinical appeals relevant to the...
with a strong mission to serve our community, we invite you to apply! Clinical Appeals Liaison Nashville, Tennessee Req ID 530206 Post... if the denial was justified Prepare comprehensive appeals packages including detailed clinical narratives and necessary...
Summary of need: We are seeking a highly motivated and experienced Grievance & Appeals Nurse Specialist... to join our team. The Grievance and Appeals Nurse Specialist participates in managing medical appeals and state hearing reviews...
and projects as assigned. What You’ll Bring: Respiratory Therapist (RT), Licensed Practical Nurse (LPN), Registered Nurse (RN...
Overview: Patient Accommodation LPN is responsible for all patient status review and related correction on discharge... as needed. Under the supervision of Utilization Review Manager the LPN will review all activity sheets and physician orders to ensure...
Job Description: Position Summary: The LPN Care Coordinator will assist the providers with medication refills... and determination of coverage of ordered medications. Coordinate and complete appeals for denials as needed Monitor and Review REMS...
or equivalent. 2. Current West Virginia licensure as a Licensed Practical Nurse (LPN). EXPERIENCE: 1. Two (2) years of healthcare.... Completes assigned appeals for retro-authorizations focusing on medical necessity. Utilizes the physician documentation when...
or equivalent. 2. Current West Virginia licensure as a Licensed Practical Nurse (LPN). EXPERIENCE: 1. Two (2) years of healthcare.... Completes assigned appeals for retro-authorizations focusing on medical necessity. Utilizes the physician documentation when...
facility benefits or services and appeals. You will document decisions using indicated protocol sets, or clinical guidelines..., unrestricted LPN/LVN licensure from the United States and in the state of hired, OR, active compact multistate unrestricted LPN...
Enjoy a truly flexible schedule and make up to $58 an hour as a Licensed Practical Nurse (LPN) in Napoleon, OH...? At IntelyCare, you can make these decisions without the risk of being denied time-off. If this appeals to you, we invite...
of professional, inpatient or outpatient, facility benefits or services, and appeals. You will also document decisions using indicated.... Microsoft Office. Active, unrestricted LPN/LVN licensure from the United States and in the state of hired, OR active compact...
to prescription information to RN/LPN/Provider. Initiates and follows-up on pre-authorizations and appeals and arranges peer-to-peer... legibly and accurately. Forwards areas requiring clinical information to LPN, RN or Licensed Provider. Secures appropriate...
to prescription information to RN/LPN/Provider. Initiates and follows-up on pre-authorizations and appeals and arranges peer-to-peer... legibly and accurately. Forwards areas requiring clinical information to LPN, RN or Licensed Provider. Secures appropriate...
disciplines and monitors work progress and completion i.e.: RN, LPN, C.N.A. Monitor resident's condition and be attuned... department's action. For more information about the appeals process, the official appeal form, and how to deliver it to the State...
reviews, including approvals, appeals, and denials, and communicates these to the appropriate personnel Monitors and tracks... in healthcare related field preferred LPN or social work degree preferred but not required Minimum of 1 year hospital or post...
), Certification Denials and Appeals Management (C-DAM), or NYS licensed RN or LPN required. LPN or RN preferred. Four (4) years... with correlating coding complexity. They will aid in training other team members, evaluating appeals, and share audit trends across the...
appeals, including leading and participating in monthly facility denial meetings. Responsible for the concurrent... in nursing or other clinical field required. Master's Degree in clinical field preferred. (RN and LPN preferred.) Six...
for interdisciplinary team Completing responses to requests for additional information from the intermediary and appeals decisions... Requirements: Current RN or LVN/LPN license in state of practice Graduate of an accredited school of nursing 1+ years...
information from the intermediary and appeals decisions. Ensuring preparation of Medicare denial letters for each resident... of documentation required for Medicaid reimbursement Requirements: Current RN or LVN/LPN license in state of practice Graduate...