Clinical Nurse Appeals Writer

If interested, you may now apply using this Workday link below: About usR1 is a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers. R1's proven and scalable operating models seamlessly complement a healthcare organization's infrastructure, quickly driving sustainable...

- PHRN/USRN with at least 3 years of clinical experience - Solid appeals writing experience for denied claims (I/OP) - Knowledge of MCG/InterQual criteria - Willingness to work onsite and on night shift schedule. Interested? APPLY NOW! Email your updated resume to athenaluna.dc@gmail.com Thank you.

Job PurposeThe Appeal Writer supports the Company by reviewing insurance claims denied for payment on behalf of our client hospitals. Working closely with nurses and other team members, the Appeal Writer creates appeal letters in support of claim payment.Duties and ResponsibilitiesReview denied insurance claimsReview patients’ medical filesDevelop...

- PHRN/USRN with at least 3 years of clinical experience- Solid appeals writing experience for denied claims (I/OP)- Knowledge of MCG/InterQual criteria- Willingness to work onsite and on night shift schedule.Interested? APPLY NOW!Email your updated resume to athenaluna.dc@gmail.comThank you.

Job Summary: The Appeal Writer reviews denied insurance claims, creates appeal letters, and manages workflow to support claim payment. The Appeal Writer plays a crucial role in supporting our client hospitals by reviewing denied insurance claims and creating appeal letters to secure payment. This position requires strong writing skills, attention to detail,...

QualificationsAt least 1 year of relevant BPO experience as a Clinical Denials and Appeals NurseMinimum of 6 mos hospital experiencePHRN licenseWilling to report onsite (McKinley West, Taguig) and on a night shift scheduleResponsibilitiesEffectively review inpatient and/or outpatient medical necessity and authorization denials to determine and understand the...

QualificationsAt least 1 year of relevant BPO experience as a Clinical Denials and Appeals NurseMinimum of 6 mos hospital experiencePHRN licenseWilling to report onsite (McKinley West, Taguig) and on a night shift scheduleResponsibilitiesEffectively review inpatient and/or outpatient medical necessity and authorization denials to determine and understand the...

Access Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Responsibilities :Perform advanced level work related to clinical denial and utilization...

Seeking a Clinical Trainer to deliver training programs within Access Healthcare's Utilization Management account, enhancing team skills and knowledge in Utilization Management, Clinical Denials, and Appeals. The ideal candidate will possess a strong background in Utilization Management, Clinical Denials, and Appeals, with a focus on high-quality service...

The Clinical Trainer will be responsible for delivering training programs within Access Healthcare's Utilization Management account. The ideal candidate must possess a strong background in Utilization Management, Clinical Denials, and Appeals, with a focus on enhancing the skills and knowledge of our team to ensure high-quality service delivery.Key...

SUMMARYThe Clinical Denials Clinician of AR Management is responsible for recovering revenue through a.) intelligent and ethical investigation of disputed/denied clinical claims, b.) verifying eligibility for clinical review, and c.) preparation and documentation of appeals based on industry-accepted criteria. He / She is also relied on when it comes to...

SUMMARYThe Clinical Denials Clinician of AR Management is responsible for recovering revenue through a.) intelligent and ethical investigation of disputed/denied clinical claims, b.) verifying eligibility for clinical review, and c.) preparation and documentation of appeals based on industry-accepted criteria. He / She is also relied on when it comes to...

Registered Nurse needed to ensure completion of patient cases by conducting roll calls, processing clinical reviews, and authorizing surgeries. Key Responsibilities: Perform advanced clinical denial and utilization management work. Manage medical denials through comprehensive review of clinical documentation. Handle audit and...

JOIN US AND BE ONE OF THE FASTEST GROWING UNIVERSITIES IN THE COUNTRY!Our Lady' of Fatima University (OLFU), is in need of FACULTY MEMBERS/CLINICAL INSTRUCTORS for the COLLEGE OF NURSING for School Year 2024-2025, Valenzuela and enjoy the benefits accorded to employees including signing bonus!Brief Job DescriptionFaculty Members/Clinical Instructors carry a...

Make your next big career move by applying as KMC Solutions’ next PHRN CLINICAL DENIALS AND APPEALS NURSE (PHRN)!The main responsibilities of a PHRN CLINICAL DENIALS AND APPEALS NURSE (PHRN) include:Effectively review inpatient and/or outpatient medical necessity and authorization denials to determine and understand the validity of such denials in a timely...

Job Summary:This position performs audits of medical records on behalf of hospital clients for denial review, disallowed charges, and utilization reviews.This position requires critical thinking and judgment and must demonstrate the ability to appropriately use standard criteria such as InterQual and MCG in addition to criteria established by state Medicaid...

QUALIFICATIONS: - Candidate must be a 4-year college graduate of BS Nursing. - Must have a valid PRC Nursing license. - No clinical or nursing experience is necessary, but preferred. - Open for fresh graduate

QUALIFICATIONS:- Candidate must be a 4-year college graduate of BS Nursing.- Must have a valid PRC Nursing license.- No clinical or nursing experience is necessary, but preferred.- Open for fresh graduate

QUALIFICATIONS: - Candidate must be a 4-year college graduate of BS Nursing. - Must have a valid PRC Nursing license. - No clinical or nursing experience is necessary, but preferred. - Open for fresh graduate

Make your next big career move by applying as KMC Solutions' next PHRN CLINICAL DENIALS AND APPEALS NURSE (PHRN)The main responsibilities of a PHRN CLINICAL DENIALS AND APPEALS NURSE (PHRN) include:Effectively review inpatient and/or outpatient medical necessity and authorization denials to determine and understand the validity of such denials in a timely...