Clinical Appeals Review Nurse Jobs
Appeals Nurse Consultant Jobs
By CVS Health
At , Hartford
$58,760 - $125,840 a year
Clinical Quality Review Nurse Trainer/Auditor - Consultant
By Blue Shield of California
At , Woodland Hills, 91367
$109,120 - $163,680 a year
Rn Appeals Nurse (Hybrid)
By VillageCare
At New York, NY, United States
Medical Review Nurse (Government Outpatient Clinical Focus)
By Performant Financial Corporation
At , Remote
Nurse Appeals (Contract) Jobs
By Elevance Health
At , Los Angeles
Medical Review Nurse (Government Outpatient Clinical Focus)
By Performant Corp
At United States
Clinical Review Nurse I
By Elevance Health
At Hingham, MA, United States
Clinical Review Nurse I
By Elevance Health
At Atlanta, GA, United States
Nurse Appeals Jobs
By Elevance Health
At Florida, United States
Nurse Appeals Jobs
By Elevance Health
At United States
Clinical Appeals Nurse Jobs
By Netsmart
At United States
Clinical Review Nurse Jobs
By Abbott
At Kansas City, MO, United States
Appeals Nurse Jobs
By Netsmart
At United States
Appeals Nurse Jobs
By Mindlance
At Ohio, United States
Nurse Appeals Jobs
By Elevance Health
At Ashburn, VA, United States
Nurse Appeals Jobs
By Elevance Health
At Columbus, OH, United States
Nurse Appeals Jobs
By Elevance Health
At Richmond, VA, United States
Nurse Appeals Jobs
By Elevance Health
At Tampa, FL, United States
Clinical Appeals Nurse Rn Wfh
By HCA Healthcare
At Nashville, TN, United States
Nurse Appeals Jobs
By Elevance Health
At Palo Alto, CA, United States
Are you a Clinical Appeals Review Nurse looking for a new challenge? Join our team and help us make a difference in the lives of our patients! We offer a competitive salary and benefits package, as well as a supportive and collaborative work environment. Come join us and make a difference today!
Overview A Clinical Appeals Review Nurse is responsible for reviewing and evaluating appeals from healthcare providers and patients regarding denied claims. They must be knowledgeable in medical coding and billing, as well as the appeals process. They must be able to identify and resolve discrepancies in claims and provide accurate and timely decisions. Detailed Job Description A Clinical Appeals Review Nurse is responsible for reviewing and evaluating appeals from healthcare providers and patients regarding denied claims. They must be knowledgeable in medical coding and billing, as well as the appeals process. They must be able to identify and resolve discrepancies in claims and provide accurate and timely decisions. They must be able to interpret and apply medical policies and procedures, as well as state and federal regulations. They must be able to communicate effectively with healthcare providers and patients, as well as other departments within the organization. Job Skills Required• Knowledge of medical coding and billing
• Knowledge of the appeals process
• Ability to interpret and apply medical policies and procedures
• Ability to identify and resolve discrepancies in claims
• Ability to provide accurate and timely decisions
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team
• Proficiency in computer applications
Job Qualifications
• Bachelor’s degree in Nursing or related field
• Current RN license
• 3+ years of experience in medical coding and billing
• Knowledge of medical terminology
• Knowledge of state and federal regulations
• Knowledge of the appeals process
Job Knowledge
• Knowledge of medical coding and billing
• Knowledge of the appeals process
• Ability to interpret and apply medical policies and procedures
• Ability to identify and resolve discrepancies in claims
• Knowledge of medical terminology
• Knowledge of state and federal regulations
Job Experience
• 3+ years of experience in medical coding and billing
• Experience in the appeals process
• Experience in interpreting and applying medical policies and procedures
• Experience in identifying and resolving discrepancies in claims
Job Responsibilities
• Review and evaluate appeals from healthcare providers and patients regarding denied claims
• Interpret and apply medical policies and procedures, as well as state and federal regulations
• Identify and resolve discrepancies in claims
• Provide accurate and timely decisions
• Communicate effectively with healthcare providers and patients, as well as other departments within the organization
- Clinical Appeals Review Nurse in Connecticut
- Clinical Appeals Review Nurse in Hartford
- Clinical Appeals Review Nurse in Tennessee
- Clinical Appeals Review Nurse in Obion
- Clinical Appeals Review Nurse in Woodland Mills
- Clinical Appeals Review Nurse in New York
- Clinical Appeals Review Nurse in New York
- Clinical Appeals Review Nurse in Iowa
- Clinical Appeals Review Nurse in Fremont
- Clinical Appeals Review Nurse in California
-
Systems Analyst - Excel, Xml, Sql, Scripting
By CyberCoders At Salt Lake City, UT, United States 8 months ago
-
(Senior) Finance & Shared Services Manager
By Catholics For Choice At Washington, DC, United States 8 months ago
-
Paralegal - Probate Administration
By CyberCoders At Miami, FL, United States 8 months ago
-
Account Executive - Automotive Software
By ECW Search At United States 8 months ago
-
Construction Project Coordinator Jobs
By CyberCoders At River Falls, WI, United States 8 months ago