Manager of Clinical Appeals - Columbus

Responsible for daily operational management of Revenue Cycle Clinical Support staff, primarily involving oversight of clinical appeals and denial analysis. · ...

The Clinical Appeals Manager is responsible for daily operational management of Revenue Cycle Clinical Support staff, primarily involving the oversight of clinical appeals and denial analysis, resolution, and prevention for The Ohio State University Health System. · Leads staff o ...

The Manager of Clinical Appeals is responsible for daily operational management of Revenue Cycle Clinical Support staff. They oversee clinical appeals and denial analysis, resolution, and prevention for The Ohio State University Health System. · ...

The Manager of Clinical Appeals will oversee clinical appeals and denial analysis for The Ohio State University Health System. · ...

The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies and procedures, and medically appropriate clinical guide ...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. · At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize sa ...

We're seeking an Appeals Nurse Consultant to join our team. You'll play a critical role in ensuring fair and accurate resolution of clinical appeals by applying sound clinical judgment and regulatory knowledge. · ...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safe ...

The Clinical Financial Case Manager - RN implements and supports the philosophy, mission, values, standards, · policies and procedures of The Ohio State University Wexner Medical Center. The CFCM-RN functions within the multidisciplinary team to secure complex pre-authorizations ...

The Appeals and Grievance Coordinator is responsible for the processing and resolution of appeals grievances disputes from members providers. · Document all appeal requests or grievances upon receipt in the operating systems routes cases to appropriate clinical personnel for revi ...

Screen reader users may encounter difficulty with this site. For assistance with applying, please contact hr- If you have questions while submitting an application, please review these frequently asked questions. · Current Employees And Students · If you are currently employed or ...

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more conveni ...

We re building a world of health around every individual — shaping a more connected convenient and compassionate health experience. · Responsible for the review and resolution of clinical appeals. · Reviews documentation and interprets data obtained from clinical records to apply ...

The Appeals and Grievance Coordinator is responsible for the processing and resolution of appeals, grievances and disputes from members and providers. · Position Purpose · The Appeals and Grievance Coordinator is responsible for the processing and resolution of appeals, grievance ...

CVS Health is seeking a dedicated Appeals Nurse Consultant to join our remote team. In this role, you will be responsible for processing the medical necessity of Medicare appeals for participating providers. · This is a full-time telework position with standard hours of Monday–Fr ...

+Job summary · Lensa partners with DirectEmployers to promote this job for Elevance Health.+ResponsibilitiesCordinates Grievance and Appeals Committee Meetings. · Serves as a resource for complex issues and interpretation of claims. · + ...

Screen reader users may encounter difficulty with this site. For assistance with applying, please contact hr- If you have questions while submitting an application, please review these frequently asked questions. · Current Employees And Students · If you are currently employed or ...

The Appeals and Grievance Coordinator is responsible for the processing and resolution of appeals, grievances and disputes from members and providers. · Document all appeal requests or grievances upon receipt in the operating systems and routes cases to appropriate clinical perso ...

The position is responsible for managing complex medical necessity denials through the appeals process and providing clinical education to payers. · ...

The Ohio Department of Medicaid (ODM) is seeking a Registered Nurse (RN) to be a part of our Surveillance/Utilization Review Section (SURS).SURS helps review utilization of Medicaid services, detect fraud, waste and abuse and recover inappropriate payments to providers. · ...