collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of cancer... for MSK employees. Job Description: RN Case Manager, Inpatient | New York, NY Exciting Opportunity at MSK...
clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical... requests Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences...
perspective on workplace flexibility. Must have RN compact licensur Position Purpose: Performs clinical reviews... needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services...
together. The Clinical Appeals RN is responsible for providing expertise in clinical appeals and grievances (analyzing..., reviewing, and evaluating appeals and grievances), and acting as a Clinical Interface Liaison (clinical problem solver...
and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance... with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices...
between $56,800.00 - $108,900.00 based on experience The RN Clinical Appeals performs all appeals for clinically related claim denials across Ensemble... Health Partners. Role also may assist with analyzing and reviewing records to prevent future denials, provide clinical...
together. As a Clinical Appeals RN for UHC Clinical Services, you will work on post-service appeals for Medicare-based claims... Responsibilities: Review provider post-service appeals for Medicare and Retirement Gather clinical information including medical...
information about this position. Design and build a health plan from the ground up as an Clinical Appeals Coordinator. Reporting... Clinical Appeals Coordinator is a collaborative member of the Medical Management team. MINIMUM QUALIFICATIONS: EDUCATION...
: This position is responsible for providing leadership and oversight of the overall clinical and non-clinical operations. Assists.... Requires minimum of five (5) years broad clinical experience. Requires minimum of three (3) years direct supervisory...
Thank you for considering a career at Ensemble Health Partners! Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician group...
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...
analytics, AI, intelligent automation, and workflow orchestration. As our Clinical Appeals and Denials Manager, you will serve... as an expert on clinical appeals and denials management. Every day you will support client hospitals where claims were denied...
Medical Reviewer - Clinical Appeals Consultant - Medical Necessity Job Summary: The Independent Medical Reviewer... assist in preventing and lowering denials and reducing the cost of the claims appeals process. Job Title: Independent...
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...
. Managed Resources is an Equal Opportunity Employer (EOE) M/F/D/V/SO clinical appeals, denials, RN, management...Clinical Appeals Manager Full time/Remote Salary: $88,000.00 - $110,000.00 per year Managed Resources is a leading...
Clinical Appeals and CDI Specialist Full time & Part time/Remote $32 - $45 per hour Coding AID, a division... The Clinical Appeals and CDI Specialist uses clinical/nursing knowledge and understanding of national coding guidelines...
JOB Title: Nurse, Clinical Appeals-- Hiring Now! 5+ Roles to be filled IMMEDIATELY! Job Description: The... Clinical Appeals Specialist completes research, basic analysis, and evaluation of member and provider disputes regarding...
Job Description: The Clinical Appeals Specialist completes research, basic analysis, and evaluation of member... and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Specialist utilizes clinical skills...
and feasibility of appeal. Consults with attending physician, physician advisor, and case managers to formulate secondary appeals... and written formal appeals using appropriate medical management tools for medical necessity determination ( MCG/Interqual/ CMS...
Anticipated End Date: 2025-02-03 Position Title: Nurse Appeals (RN) CA Job Description: Nurse Appeals – Licensed... and serves as a subject matter expert for appeals/grievances/quality of care issues and is a resource for clinical and non...