Clinical Appeals Nurse - Durham

The Nurse Appeals Senior is responsible for investigating and processing the most complex appeals requests from members and providers. · Conducts investigations and reviews of member and provider appeals. · Reviews prospective, inpatient, or retrospective medical records of denie ...

The Clinical Appeal and Grievance Nurse conducts daily clinical reviews in a quality-focused environment. They review medical necessity cases using member-specific benefit information. This role reports directly to the Clinical Appeal Manager. · ...

+Job summary · A rewarding opportunity exists for a registered nurse specializing in oncology to provide compassionate expert care in a dynamic hospital environment. · +Qualifications And Desired ExperienceValid RN licensure in North Carolina or Compact licensed · Minimum of 2 ye ...

Assesses for accuracy in the assignment of patient class (status) to reflect congruence with clinical condition, physician intent, and utilization review outcomes with current rules and regulatory requirements. · ...

Assists in the planning implementation and evaluation of recreational social intellectual emotional and spiritual programs in accordance with the patient's assessment and care plan as directed by the Supervisor. · Conducts assessments gathers information by interviewing residents ...

Assists in planning implementation and evaluation of recreational social intellectual emotional and spiritual programs. · ...

Acentra Health is seeking clinical assessors statewide in North Carolina for an exciting opportunity. · Conducts assessment to determine whether the beneficiary meets the conditions and criteria for PCS eligibility. · ...

Acentra Health seeks a Clinical Assessor to join its team statewide in North Carolina. · ...

Acentra Health is looking for a Clinical Assessor to join our growing team. · ...

We're seeking a Medical Coder Specialist to join our team at Duke Health. · Pursue your passion for caring with the Patient Revenue Management Organization, · ...

+Job summary · Duke Health busca un especialista en codificación médica para trabajar en su organización de gestión de ingresos del paciente. El candidato ideal tendrá experiencia en codificación quirúrgica y aplicaciones relevantes. · +ResponsibilitiesCodificar procedimientos qu ...

Acentra Health busca un asesor clínico para formar parte de su equipo creciente. · Acepta la oportunidad de trabajar como asesor clínico en una posición hibrida. El candidato debe estar basado en el condado de Durham (NC) para poder cubrir los trabajos fuera del hogar requeridos. ...

The Assistant Director Annual Giving position is an essential role in advancing a unified integrated approach to annual giving across the School of Medicine SOM and Duke University Health System DUHS. · ...

+ Patient Financial Coordinator - Job summary: Coordinate administrative services & operations for transplant financial services. + Qualifications: High School Diploma required. Advanced degree preferred. Three years of healthcare experience with a minimum of one year in insuranc ...

The Patient Financial Coordinator coordinates administrative services and operations for transplant financial services at Duke Health. This role involves providing accurate and professional financial clearance to patients seeking transplant services. · ...

Duke Health busca un Utilization Manager que asuma la responsabilidad de validar la autorización de pacientes hospitalizados y comerciales dentro del plazo contractual. El candidato ideal tendrá experiencia en gestión clínica y análisis de datos para determinar la necesidad médic ...

We are driven by a commitment to compassionate care that changes the lives of patients and their loved ones. Join us at Duke Health in Durham North Carolina. · ...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. · ...

+The Registered Nurse (RN) for the Duke Children's Partial Hospitalization Program plays a key role in supporting the medical, psychiatric, and safety needs of pediatric patients receiving intensive outpatient behavioral health treatment. · +Duke University Health System is desig ...

Assesses for accuracy in the assignment of patient class (status) to reflect congruence with clinical condition, physician intent, and utilization review outcomes with current rules and regulatory requirements. · ...