RN Clinical Appeals Reviewer

VirtualVocationsYonkers, New York, United States

30+ days ago

Job type

Full-time

Job description

A company is looking for an IBR Clinical Appeals Reviewer - Remote.

Key Responsibilities

Analyze and respond to IBR Appeals inquiries

Perform medical record reviews and prepare written appeals

Collaborate with auditors and leadership to review impacted claims

Required Qualifications

Undergraduate nursing degree

Unrestricted RN (registered nurse) license

2+ years of appeals experience (coding or auditing)

Experience with CPT-4 and ICD10 CM / PCS coding

Advanced knowledge of regulations and compliance in appeals

Create a job alert for this search

Rn Clinical • Yonkers, New York, United States

Related jobs

Promoted

Michigan Licensed Clinical Document Specialist

VirtualVocationsPaterson, New Jersey, United States

Full-time

A company is looking for a Clinical Document Specialist for a full-time remote position.Key Responsibilities Utilize clinical, coding, and Clinical Documentation Integrity (CDI) knowledge to enha...Show moreLast updated: 2 days ago

Promoted

Inpatient DRG Reviewer

Zelis Healthcare, LLCMorristown, NJ, United States

Full-time

Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers.We serve more than 750 payers, including the top five national health plans, regional hea...Show moreLast updated: 30+ days ago

Promoted

Health Information Specialist

VirtualVocationsNewark, New Jersey, United States

Full-time

A company is looking for a Health Information Specialist I.Key Responsibilities Process medical record requests by communicating with patients, insurance companies, and attorneys Document inform...Show moreLast updated: 30+ days ago

Promoted

Prior Authorization Specialist

VirtualVocationsYonkers, New York, United States

Full-time

A company is looking for a Prior Authorization Specialist to manage the initiation and processing of prior authorization requests. Key Responsibilities Initiate, process, and oversee clinical revi...Show moreLast updated: 30+ days ago

Promoted

Pennsylvania Licensed Clinical Appeals Reviewer

VirtualVocationsBrooklyn, New York, United States

Full-time

A company is looking for a Clinical Appeals Reviewer.Key Responsibilities Process appeals while ensuring compliance with regulatory milestones Review medical records for documentation and billin...Show moreLast updated: 1 day ago

Promoted

Medical Records Coordinator

VirtualVocationsBronx, New York, United States

Full-time

A company is looking for a PEND Management Coordinator to manage PEND inventory and coordinate medical records requests.Key Responsibilities Manage outbound and inbound calling campaigns related ...Show moreLast updated: 30+ days ago

Promoted

State Licensed Utilization Review Nurse

VirtualVocationsBronx, New York, United States

Full-time

A company is looking for a Utilization Review Nurse (PRN).Key Responsibilities Review and evaluate electronic medical records for emergency admissions to assess medical necessity Apply clinical ...Show moreLast updated: 30+ days ago

Promoted

South Carolina Licensed RN Reviewer

VirtualVocationsPaterson, New Jersey, United States

Full-time

A company is looking for an RN Medical Reviewer II to perform medical reviews and support medical claims processing.Key Responsibilities Conduct medical claim reviews for complex services and det...Show moreLast updated: 1 day ago

Promoted
New!

South Dakota Licensed Clinical Documentation Specialist

VirtualVocationsFlushing, New York, United States

Full-time

A company is looking for a Clinical Documentation Specialist - Home and Community Based Services (HCBS) - FT Days.Key Responsibilities Communicate with healthcare team members to ensure comprehen...Show moreLast updated: 13 hours ago

Promoted

Chief Medical Information Officer (CMIO)

Memorial SloanNew York, NY, United States

Full-time

The people of Memorial Sloan Kettering Cancer Center (MSK) are united by a singular mission : ending cancer for life.Our specialized care teams provide personalized, compassionate, expert care to pa...Show moreLast updated: 20 days ago

Promoted

RN, Chart Reviewer

ProKatchers LLCNew York, NY, US

Temporary

Water Street, New York, NY 10004.Review medical records and healthcare claims to determine the accuracy and compliance of billed codes with appropriate regulations, standards, policies and procedur...Show moreLast updated: 21 days ago

Promoted

Medical Records Specialist

VirtualVocationsFlushing, New York, United States

Full-time

A company is looking for a Medical Records Specialist.Key Responsibilities Coordinate and oversee the collection and administration of medical records from healthcare providers Create thorough c...Show moreLast updated: 30+ days ago

Promoted

Patient Access Specialist

VirtualVocationsFlushing, New York, United States

Part-time

A company is looking for a Patient Access Specialist, Part-time, Days (Remote - Must reside in IL, IN, IA, or WI).Key Responsibilities Provide exceptional customer service and maintain patient co...Show moreLast updated: 30+ days ago

Promoted

Prior Authorization Specialist

BrightSpring Health ServicesTotowa, NJ, United States

Full-time

Prior Authorization Specialist.This role will be responsible for activities relating to the proper initiation, clinical review, submission, and follow up of prior authorizations.This role requires ...Show moreLast updated: 30+ days ago

Promoted

Medical Bill Navigator

Zelis Healthcare, LLCMorristown, NJ, United States

Full-time

Promoted

Remote Medical Insurance Verifier

VirtualVocationsBronx, New York, United States

Remote

Full-time

A company is looking for a Remote Medical Insurance Verification Specialist.Key Responsibilities Assist patients with obtaining coverage for prescription medications Make inbound / outbound calls ...Show moreLast updated: 2 days ago

Promoted

Health Information Specialist I

VirtualVocationsPaterson, New Jersey, United States

Full-time

A company is looking for a Health Information Specialist I - OnBase Indexer.Key Responsibilities : Perform chart processing functions including preparation, scanning, indexing, and quality review ...Show moreLast updated: 2 days ago

Promoted

Patient Intake Coordinator

VirtualVocationsJamaica, New York, United States

Full-time

A company is looking for a Patient Intake Coordinator - Specialty Pharmacy.Key Responsibilities Support patients and providers in navigating insurance benefits for prescribed injectable therapies...Show moreLast updated: 30+ days ago

Promoted

Licensed Physician Reviewer

VirtualVocationsPaterson, New Jersey, United States

Full-time

A company is looking for a Physician Reviewer - Utilization Review.Key Responsibilities Conduct timely medical reviews to ensure compliance with quality parameters Make clinical determinations b...Show moreLast updated: 1 day ago

Promoted

Prior Authorization Specialist / Remote

BrightSpring Health ServicesNew Hyde Park, NY, United States

Remote

Full-time

Prior Authorization Specialist / Remote.This role will be responsible for activities relating to the proper initiation, clinical review, submission, and follow up of prior authorizations.This role ...Show moreLast updated: 12 days ago