Clinical Appeals RN - Nashville, TN

We are currently seeking an experienced RN with strong interpersonal skills to join our team. The chosen Clinical Appeals & Coding RN would be responsible for reviewing appeals and grievances to determine if the appropriate care was given.In providing Medicaid Community and State ...

We are currently seeking an experienced RN with strong interpersonal skills to join our team. · The chosen Clinical Appeals & Coding RN would be responsible for reviewing appeals and grievances to determine if the appropriate care was given. · ...

The Clinical Appeals Nurse is responsible for handling appeals requiring clinical input or interpretation.,Responsibilities · ,Compose clinical appeal letters to send to payers for denial considerations utilizing documentation, contract language, or voice recordings as applicable ...

+The Clinical Appeals Specialist is a key clinical expert within the new Revenue Recovery Team at Amplify RCM. · +Perform comprehensive reviews of denied claims,focusing on clinical issues such as medical necessitylevel of care non-covered services,and authorization-related denia ...

We Believe That Investing In Our Employees Is The First Step To Providing Excellent Patient Care. At Lifepoint Health, we are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. · Here's What Makes Us Stand Out · Specialize ...

The Supervisor Clinical Appeals oversees the coordination of audit and medical necessity denial appeals for their assigned team. · Supervises the team responsible for reviewing preparing and submitting medical necessity denial appeals in accordance with standardized processes and ...

The Supervisor, Clinical Appeals oversees the coordination of audit and medical necessity denial appeals for their assigned team.This role ensures timely and accurate appeal submissions, compliance with regulatory standards, and the achievement of service and production goals. · ...

Clinical Appeals Liaison · Leverage clinical expertise to review and analyze insurance denials in order to initiate appeal letters. · ...

Leverage your clinical expertise to review and analyze insurance denials in order to initiate appeal letters as a Clinical Appeals Liaison at Lifepoint Health. · Review denied insurance claims for medical treatment. · Analyze patient medical records to determine if the denial was ...

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The Denials Management Specialist position at Houston Methodist leads in reviewing coordinating monitoring clinical denial management appeals process collaborating with Central Business Office management clinical partners to reduce financial risk exposure caused by denials. This ...

The Claims Appeals Specialist is responsible for reviewing and processing claims for pre services and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) related to clinical and non-clinical services, · quality of s ...

· Hybrid schedule: Nashville TN · About Lucent Health  · Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan parti ...

BlueCross BlueShield of South Carolina is hiring an Appeals Analyst to research and analyze complex appeals and retrospective review requests.Research the substance of service appeals by both member and provider based on clinical documentation. · Perform thorough research of appe ...

Bridgehealth Partners is seeking a Family Medicine Physician to join a well-respected and very busy community-based practice in Mt. Juliet, Tennessee, just 20 miles outside of Nashville. Ideal candidates will possess excellent clinical, collaborative and communication skills, be ...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team.Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.Po ...

+Job summary · The Collections Coordinator is responsible for performing all collections functions after claims have been submitted and processed. · +ResponsibilitiesExecutes targeted follow-up on outstanding accounts with Medicare, Medicaid, and commercial carriers based on AR a ...

The Utilization Specialist proactively monitors utilization of services for patients to optimize reimbursement for the facility. · ...

+The Claims Appeals Specialist is responsible for reviewing, analyzing and processing claims for pre services and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple products (i.e. HMO, POS, PPO, EPO, C ...

We are currently hiring for an Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as Appeals Analyst, you will research the substance of complex appeal or retrospective review requests including pre-pay and post-payment review appeal requests. · Addition ...