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Search parameters used for this particular query: Clinical Appeals Specialistjob / career / vacancy; job location: United States of America (USA). We found several listings that are shown below (part time / full time jobs / jobs near me).
Job Description: Preparing and advising on quality of care reviews and appeals. Analyzing trends within appeals relative to the UM process and providing feedback for improvement…
Company: Devoted Health Hiring Organization: Devoted Health Salary: TBD
Location: Remote Street Address: TBD
Locality: Remote Region: disclosed when applied Postal code: disclosed when applied
Job Description: Assists in the appeal process resulting from third-party reviews. Assists with preparation and presentation of clinical documentation monitoring/trending…
Company: Driscoll Health Hiring Organization: Driscoll Health Salary: TBD
Location: Texas Street Address: TBD
Locality: Texas Region: disclosed when applied Postal code: disclosed when applied
Job Description: Ensures clinical reviews and appeals are up to date and accurately reflect patient’s severity of illness and intensity of services provided.
Company: Northwell Health Hiring Organization: Northwell Health Salary: TBD
Location: Melville, NY 11747 Street Address: TBD
Locality: Melville, NY 11747 Region: disclosed when applied Postal code: disclosed when applied
Job Description: Ability to communicate with all levels of clinical staff. Demonstrated understanding and ability to recognize complex diagnoses, clinical complications and co…
Job Description: Develops correspondence communicating the outcome of grievances and appeals to enrollees and/or providers. Creates and maintains accurate records documenting…
Company: VNS Health Hiring Organization: VNS Health Salary: TBD
Location: Manhattan, NY Street Address: TBD
Locality: Manhattan, NY Region: disclosed when applied Postal code: disclosed when applied
Job Description: Ensure the appeals are concluded successfully and accurately. The Appeals & Resolution Specialist is responsible for implementing Chapter 7 of the.
Company: Westside Regional Center Hiring Organization: Westside Regional Center Salary: TBD
Location: Culver City, CA 90230 Street Address: TBD
Locality: Culver City, CA 90230 Region: disclosed when applied Postal code: disclosed when applied
Job Description: Audits third party vendors to ensure clinical appeals opportunities are identified and realized. Analyzes and interprets clinical denials received through the…
Company: Stony Brook University Hospital Hiring Organization: Stony Brook University Hospital Salary: TBD
Location: East Setauket, NY Street Address: TBD
Locality: East Setauket, NY Region: disclosed when applied Postal code: disclosed when applied
Job Description: Escalate exhausted appeal efforts for resolution. Coordinate with the Clinical Resource Center (CRC) for clinical consultations or account referrals when…
Job Description: Provides education on navigating the appeals process as well as denied and partially paid claims, and specialty pharmacy and buy & bill acquisition options.
Company: Glaukos Corporation Hiring Organization: Glaukos Corporation Salary: TBD
Location: Aliso Viejo, CA Street Address: TBD
Locality: Aliso Viejo, CA Region: disclosed when applied Postal code: disclosed when applied
Job Description: Manage adverse determinations per policy and procedural guidelines including up to first level appeal when indicated. AREA OF ASSIGNMENT: Case Management.
Company: Valley Medical Center Hiring Organization: Valley Medical Center Salary: TBD
Location: Renton, WA Street Address: TBD
Locality: Renton, WA Region: disclosed when applied Postal code: disclosed when applied
Job Description: Performs clinical review of medical records related to grievances and appeals. Works with Registered Nurses and Medical Directors to appropriately investigate,…
Company: L.A. Care Health Plan Hiring Organization: L.A. Care Health Plan Salary: TBD
Location: Los Angeles, CA 90017 Street Address: TBD
Locality: Los Angeles, CA 90017 Region: disclosed when applied Postal code: disclosed when applied
Job Description: Serves as clinical resource consultant to HIM coding staff when coders require clinical decision-making and clinical interpretation to determine appropriate…
Company: Riverview Health Hiring Organization: Riverview Health Salary: TBD
Location: Noblesville, IN 46060 Street Address: TBD
Locality: Noblesville, IN 46060 Region: disclosed when applied Postal code: disclosed when applied
Job Description: 3+ years reimbursement or sales experience with physician-administered injectables and/or medical devices, Category III CPT codes and/or miscellaneous J-codes,…
Company: Glaukos Corporation Hiring Organization: Glaukos Corporation Salary: TBD
Location: United States Street Address: TBD
Locality: United States Region: disclosed when applied Postal code: disclosed when applied
Job Description: Minimum 3 years of CDI experience or experience with clinical inpatient DRG Downgrades and clinical denial. Collaborates with Accuity Physician and Accuity CDI…
Company: Accuity Hiring Organization: Accuity Salary: TBD
Location: New Jersey Street Address: TBD
Locality: New Jersey Region: disclosed when applied Postal code: disclosed when applied
Job Description: Coordinates follow-up activities with Utilization Review/Case Management/Coding/Nurse Liaison to provide required clinical support, as well as to ensure timely…
Company: Trinity Health Hiring Organization: Trinity Health Salary: TBD
Location: Farmington Hills, MI 48331 Street Address: TBD
Locality: Farmington Hills, MI 48331 Region: disclosed when applied Postal code: disclosed when applied
Job Description: SUMMARY: Coordinates and executes the appeal process for all AHS facilities clinical appeals and third party audits. Identifies and documents quality incidents.
Company: Alameda Health System Hiring Organization: Alameda Health System Salary: TBD
Location: San Leandro, CA 94578 Street Address: TBD
Locality: San Leandro, CA 94578 Region: disclosed when applied Postal code: disclosed when applied
Job Description: Under limited supervision, the appeals specialist evaluates clinical information basic to complex medical claims and/or appeal cases and associated records by…
Company: MUSC Hiring Organization: MUSC Salary: TBD
Location: South Carolina Street Address: TBD
Locality: South Carolina Region: disclosed when applied Postal code: disclosed when applied
Job Description: Extensive knowledge of disease processes and clinical outcomes. This position is responsible for assisting in the overall integrity of the medical records…
Company: Mercy Hiring Organization: Mercy Salary: TBD
Location: Springfield, MO 65804 Street Address: TBD
Locality: Springfield, MO 65804 Region: disclosed when applied Postal code: disclosed when applied
Job Description: Download generated appeal letters from insurance follow-up through a billing shared application and attach any required documentation, such as clinical reports,…
Job Description: Offers technical guidance, information and assistance to management and senior leadership officials on sensitive, serious, and controversial labor relations…
Company: US Veterans Health Administration Hiring Organization: US Veterans Health Administration Salary: TBD
Location: Prescott, AZ Street Address: TBD
Locality: Prescott, AZ Region: disclosed when applied Postal code: disclosed when applied
Job Description: Reviews denials for accurate and complete documentation and develops appeal letter when needed. Assures documentation in chart represents a true clinical…
Company: Carle Health Hiring Organization: Carle Health Salary: TBD
Location: Urbana, IL Street Address: TBD
Locality: Urbana, IL Region: disclosed when applied Postal code: disclosed when applied
Data as of 2023-12-04 (Cached) with id 148453. Database job listings: 1,214,315 jobs and growing. Find more jobs near me.
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