Clinical Nurse Appeals Specialist

Job Title: Clinical Nurse Appeals WriterJob Summary:We are seeking a skilled Clinical Nurse Appeals Writer to join our team at Dencom Consultancy. As a key member of our appeals team, you will be responsible for writing high-quality appeals for denied claims, utilizing your expertise in MCG/InterQual criteria.Key Responsibilities:Develop and write...

Job Title: Clinical Nurse Appeals WriterWe are seeking a skilled Clinical Nurse Appeals Writer to join our team at Dencom Consultancy.Key Responsibilities:Developing and writing high-quality appeals for denied claimsCollaborating with clinical teams to ensure accurate and effective appealsStaying up-to-date with MCG/InterQual criteria and industry...

Job RequirementsWe are seeking a skilled Clinical Nurse Appeals Writer to join our team at Dencom Consultancy.Key Responsibilities:Collaborate with healthcare professionals to develop effective appeals strategies.Write compelling appeals documents that showcase clinical expertise and knowledge of MCG/InterQual criteria.Work closely with onsite teams to...

Key Responsibilities:- Collaborate with experienced clinical professionals to develop and implement effective appeals strategies for denied claims.- Utilize in-depth knowledge of MCG/InterQual criteria to craft compelling appeals that drive successful outcomes.- Work closely with the team to ensure seamless communication and efficient workflow.Requirements:-...

Job Requirements:- Possess a strong clinical background with at least 3 years of experience as a PHRN/USRN.- Proven track record of writing effective appeals for denied claims in the I/OP setting.- In-depth knowledge of MCG/InterQual criteria is essential for success in this role.Work Environment:- Willingness to work on-site and adapt to a night shift...

**Clinical Denials and Appeals Nurse** **Summary:** Review medical necessity and authorization denials, conduct comprehensive reviews of claim denials, and write appeal letters to payers using clinical indicators and documentation from patient medical records. **Responsibilities:** Review inpatient and/or outpatient medical necessity and authorization...

Clinical Denials and Appeals NurseWe are an analytics-driven, technology-enabled revenue cycle management company looking for a skilled Clinical Denials and Appeals Nurse with at least 1 year of relevant BPO experience. The ideal candidate will have a PHRN license, 6 months of hospital experience, and be willing to work a night shift...

Job Requirements:- A PHRN/USRN with at least 3 years of clinical experience is required for this role.- The ideal candidate will have solid appeals writing experience for denied claims (I/OP).- Knowledge of MCG/InterQual criteria is essential for success in this position.- The successful candidate will be willing to work onsite and on night shift...

Job Description**Summary:** Clinical Denials and Appeals Nurse with 1+ year BPO experience, PHRN license, and 6+ months hospital experience, willing to work onsite at McKinley West, Taguig, on a night shift schedule.**Responsibilities:*** Review inpatient and/or outpatient medical necessity and authorization denials to determine validity.* Conduct...

Recover revenue and drive process improvement as a Clinical Denials Clinician in a healthcare setting.Responsibilities include:Providing expertise to non-clinical personnel on clinical mattersCollaborating with leadership to develop and implement process improvementsAssisting in the development of policies and proceduresReviewing medical necessity cases and...

Key Requirements:- Possess at least 3 years of clinical experience as a PHRN/USRN.- Demonstrate strong appeals writing skills for denied claims (I/OP).- Possess in-depth knowledge of MCG/InterQual criteria.Working Conditions:- Willingness to work onsite and adapt to a night shift schedule.Interested in this role?Learn more about our company culture and apply...

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...

Clinical Denials Clinician recovers revenue through intelligent investigation of disputed claims, verifying eligibility, and preparing appeals based on industry-accepted criteria. They synergize with the Denials team on processes and best practices. Responsibilities include serving as a resource, providing process improvements, and performing medical...

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...

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 Title: Clinic NurseAt CloudMatrix Innovations, we are seeking a highly skilled and dedicated Clinic Nurse to join our team. As a Clinic Nurse, you will be responsible for providing high-quality patient care and support to our clients.Qualifications:Candidate must be a 4-year college graduate of BS Nursing.Must have a valid PRC Nursing license.No clinical...

Job Title: Clinical Nurse Data AnalystWe are seeking a highly skilled Clinical Nurse Data Analyst to join our team at RecruiterPH. As a key member of our team, you will be responsible for collaborating with healthcare providers and members to promote quality member outcomes, optimize member benefits, and promote effective use of...

Job Summary: Medical Sales Specialist required to provide high-quality care and attention to customers throughout the sales and service process of medical technology procured. Job Requirements: Hold a Bachelor's/College Degree in Nursing, Medical Technology, Biology, Chemistry, Physical Therapy, Radiologic Technology or equivalent. Experience in medical...

Job Title: Customer Execution and Clinical Monitoring SpecialistRippedboxstation is seeking a highly skilled Customer Execution and Clinical Monitoring Specialist to join our team. In this role, you will be responsible for ensuring the smooth execution of clinical monitoring services for our patients.Key Responsibilities:Screen patients for Medicare and...

Job Title: Registered Nurse for Doctors ClinicWe are seeking a skilled and compassionate Registered Nurse to join our team at ACTFA Medical & Laboratory Diagnostics. As a key member of our healthcare team, you will play a vital role in providing high-quality nursing care to our patients.Responsibilities:Perform routine procedures, including blood pressure...