RN Clinical Appeals ReviewerVirtualVocations • Norwalk, California, United States
No longer accepting applications
RN Clinical Appeals Reviewer
VirtualVocations • Norwalk, California, 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
Clinical Rn • Norwalk, California, United States
Related jobs
Critical Care Float Pool RN at Providence Mission Hospital in Mission Viejo, CA.Positions available are Part-time and will work 12-hour Night shifts.
The Critical Care Float Pool is a dynamic team o...Show more A company is looking for an Appeals Nurse Consultant (Remote).Key Responsibilities Review and resolve clinical appeals Interpret data from clinical records to apply clinical criteria and policie...Show more 
There's nothing more exciting and rewarding than being able to make a significant, positive difference in someone's life.
At UCLA Health, you'll experience this joy every day while also enjoying the...Show more A company is looking for an RN Case Manager - Transition of Care (Outpatient, Bilingual Spanish or Vietnamese) - Remote.Key Responsibilities Develop and manage personalized discharge care plans ...Show more 
As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations.
As the facility leader, you will be part of a close-k...Show more A company is looking for a Clinical Review Clinician - Appeals.Key Responsibilities Performs clinical reviews to resolve and process appeals by analyzing medical records and clinical data Ensure...Show more A company is looking for a Care Coordinator - Clinical Appeals RN.Key Responsibilities Perform medical necessity reviews for inpatient, outpatient, and retrospective cases to ensure compliance wi...Show more 
TravelNurseSource is working with GetMed Staffing to find a qualified Case Manager RN in Mission Hills, California, 91345!.
GetMed Staffing is searching for a strong Case Manager RN to assist our tr...Show more A company is looking for a Denials and Appeals Administrator.Key Responsibilities Manage the pre-denial, denial, and appeal processes, ensuring compliance with nationally accepted admission crite...Show more Critical Care Float Pool RN at Providence Mission Hospital in Mission Viejo, CA.Position available are full-time and will work 12-hour Night shifts.
The Critical Care Float Pool is a dynamic team of...Show more A company is looking for an RN Concurrent Review.Key Responsibilities Monitor and document medical treatment telephonically, ensuring compliance with established guidelines Track patient progres...Show more TravelNurseSource is working with Atlas MedStaff to find a qualified Case Manager RN in Apple Valley, California, 92307!.
Atlas Medstaff is currently seeking candidates in the RN (Case Manager) prof...Show more A company is looking for an RN Clinical Appeals.Key Responsibilities Review denials and perform root cause analysis to improve processes and reduce denials Contact insurance plans to determine r...Show more 
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care.
The work you do here impacts the lives of millions of people ...Show more A company is looking for a Utilization Review Clinician - ABA.Key Responsibilities Evaluates member's care and health status related to Applied Behavioral Analysis (ABA) services to ensure medica...Show more TravelNurseSource is working with Atlas MedStaff to find a qualified Case Manager RN in Mission Viejo, California, 92691!.
Atlas Medstaff is currently seeking candidates in the RN (Case Manager) pro...Show more TravelNurseSource is working with OneStaff Medical to find a qualified Case Manager RN in Mission Viejo, California, 92691!.
An independently-owned, nationally-recognized and amazingly awesome staff...Show more A company is looking for a Clinical Appeals RN - Remote.Key Responsibilities : Perform medical reviews on provider inquiries and member appeals Ensure compliance with Department of Labor and Stat...Show more
RN Critical Care Float Pool - Part-Time Nights
Providence • Mission Viejo, CA, US
Part-time
Last updated: 11 days ago • Promoted
RN Appeals Nurse Consultant
VirtualVocations • North Hollywood, California, United States
Full-time
Last updated: 30+ days ago • Promoted
RN Case Manager - Complex Cases
University of California - Los Angeles Health • Santa Monica, CA, United States
Full-time
Last updated: 5 days ago • Promoted
California Licensed RN Case Manager
VirtualVocations • Glendale, California, United States
Full-time
Last updated: 30+ days ago • Promoted
RN
Fresenius Medical Care • Bellflower, CA, US
Full-time
Last updated: 7 hours ago • Promoted • New!
RN Clinical Review Clinician
VirtualVocations • Norwalk, California, United States
Full-time
Last updated: 30+ days ago • Promoted
Clinical Appeals Care Coordinator RN
VirtualVocations • Norwalk, California, United States
Full-time
Last updated: 4 days ago • Promoted
Travel Registered Nurse (RN) - Case Manager - $2,282 per week in Mission Hills, CA
TravelNurseSource • Mission Hills, CA, US
Full-time
Last updated: 4 days ago • Promoted
RN Appeals Administrator
VirtualVocations • Fullerton, California, United States
Full-time
Last updated: 1 day ago • Promoted
RN Critical Care Float Pool - Nights Full-Time
Providence • Mission Viejo, CA, US
Full-time
Last updated: 16 days ago • Promoted
Texas Licensed Concurrent Review RN
VirtualVocations • Fullerton, California, United States
Full-time
Last updated: 4 days ago • Promoted
Travel Registered Nurse (RN) - Case Manager - $1,662 per week in Apple Valley, CA
TravelNurseSource • Los Angeles, California, US
Full-time
Last updated: 1 day ago • Promoted
Virginia Licensed RN Clinical Appeals
VirtualVocations • Glendale, California, United States
Full-time
Last updated: 30+ days ago • Promoted
Clinical Appeals RN - Remote in EST or CST Time Zone
UnitedHealth Group • Cypress, CA, United States
Full-time
Last updated: 22 days ago • Promoted
Licensed Utilization Review Clinician
VirtualVocations • North Hollywood, California, United States
Full-time
Last updated: 30+ days ago • Promoted
Travel Registered Nurse (RN) - Case Manager - $2,303 per week in Mission Viejo, CA
TravelNurseSource • Mission Viejo, CA, US
Full-time
Last updated: 17 hours ago • Promoted • New!
Travel Registered Nurse (RN) - Case Manager - $2,401 per week in Mission Viejo, CA
TravelNurseSource • Mission Viejo, CA, US
Full-time
Last updated: 17 hours ago • Promoted • New!
Wisconsin Licensed Clinical Appeals RN
VirtualVocations • Van Nuys, California, United States
Full-time
Last updated: 30+ days ago • Promoted