Clinical Review Nurse

Job description:Clinical Appeals Specialist is responsible in writing a compelling and effective appeal based on the clinical Documentation, payer-specific policies and is compliant to Federal and State policies. The Clinical Appeals Specialist is responsible for appeals and follow-up on clinical denials, providing appropriate denial information to be...

Company DescriptionAt Coronis Health, we specialize in revenue cycle management (RCM) with a focus on simplifying complexities for healthcare providers to enable them to deliver exceptional patient care. We offer tailored solutions for billing optimization, claims management, and actionable insights to support growth and scalability for each unique practice....

Pilot Activities The team will undertake the following activities during the pilot: Patient Interaction: The nurses will interact with patients primarily located in the United States via email, text, and voice communication channels. Phone\Video Screening: The nurses will conduct thorough phone screens with patients using a predetermined script based on the...

Job DescriptionTo assist the clinic nurse by providing a defined set of patient care activities and related services necessary in caring for the personal needs and comfort of the patientQualificationsPreferably with at least 3 months of patient care experience (Home-Based or Hospital).Must be a graduate of Bachelor of Science in Nursing & Certified Caregiver...

JOB SUMMARY:The Clinical Appeals Nurse is responsible for creating a convincing and effective appeal based on clinical documentation, payer-specific standards, and compliance with federal and state policies. The Clinical Appeals Nurse is responsible for handling clinical denial appeals and follow-up, providing relevant denial information to departments to...

We are driven by our commitment to deliver exceptional care and improve the quality of life for every resident we serve. We believe that excellence in care comes from compassion, collaboration, and a relentless focus on clinical integrity.We are seeking aCalifornia-licensed Registered Nurse (RN)based in thePhilippinesto join our team. This role supports our...

TASQ is seeking a USRN case manager to join their team in Pasig on-site as soon as possible.The pre-screening interview will be done over the phone.Qualifications:- Bachelor's degree in nursing; a USRN license is mandatory.- A minimum of 1 year of hospital nursing or case management experience within a clinical setting for a US-based healthcare organization...

The Medical City Ortigas is searching for an experienced Nursing Instructor to join the team and help lead the organization to the next level. This role is crucial for implementing comprehensive and ethical end-to-end nursing educational programs that adhere to standards of practice and professional regulations.This role reports directly to the Head of the...

The PH Registered Nurse (PHRN) collaborates with healthcare providers and members to promote quality outcomes, optimize member benefits, and ensure the effective use of healthcare resources. This role ensures that care provided is medically appropriate, high-quality, and cost-effective by reviewing medical necessity for inpatient admissions, outpatient...

Job Description:The Company Nurse will be responsible for promoting and maintaining the health and well-being of KDCI employees. The Company Nurse also coordinates with healthcare providers (HMO, clinics, hospitals) and contributes to employee engagement by leading health-related activities.Responsibilities:• Provide first aid, medical care, and emergency...