RN Clinical Appeals Reviewer

VirtualVocationsCranston, Rhode Island, 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 • Cranston, Rhode Island, United States

Related jobs

Promoted

Health Information Specialist I

VirtualVocationsCranston, Rhode Island, 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
New!

Certified Medical Coder III

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for a Medical Coder III with Cardiology experience.Key Responsibilities Review and submit 64 encounters per day related to various cardiology services Maintain coding knowle...Show moreLast updated: 18 hours ago

Promoted
New!

Senior Clinical Data Coordinator

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for a Senior Clinical Data Coordinator who will execute and support data management tasks across various program types. Key Responsibilities Support study design, eCRF design,...Show moreLast updated: less than 1 hour ago

Promoted

Insurance Authorization Specialist

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for an Insurance Specialist responsible for authorizing appointments and procedures.Key Responsibilities Identify patients requiring pre-certification or pre-authorization fo...Show moreLast updated: 30+ days ago

Promoted

Health Information Analyst

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for a Health Information Discharge Analyst I.Key Responsibilities Reviews inpatient records to ensure completion of discharge summaries and identifies deficiencies Updates d...Show moreLast updated: 30+ days ago

Promoted

Licensed RN Clinical Appeals Reviewer

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for an IBR Clinical Appeals Reviewer who will analyze and respond to client and hospital claim review appeal inquiries. Key Responsibilities : Analyze scope and resolution of I...Show moreLast updated: 1 day ago

Promoted

Certified Medical Coder - IL

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for a HIM Certified Coder.Key Responsibilities Accurately code hospital inpatient, outpatient, and professional fee encounters using appropriate coding systems Provide inter...Show moreLast updated: 2 days ago

Promoted

Prior Authorization Specialist

VirtualVocationsCranston, Rhode Island, 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

VirtualVocationsCranston, Rhode Island, 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
New!

State Licensed Clinical Content Reviewer

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for a Clinical Content Editor - PGY-1 / Medical Students.Key Responsibilities Collaborate with a multidisciplinary team to create and curate content on emerging medical technol...Show moreLast updated: 8 hours ago

Promoted

Patient Intake Coordinator

VirtualVocationsCranston, Rhode Island, 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

Clinical Response Specialist

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for a Clinical Response Specialist - PRN.Key Responsibilities Assist patients, families, and providers in navigating the admissions process Complete intake calls and manage ...Show moreLast updated: 1 day ago

Promoted
New!

Patient Authorization Specialist

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for a Patient Connection Authorization Associate to manage pre-certifications and authorizations for outpatient services. Key Responsibilities Secure pre-certifications and au...Show moreLast updated: 8 hours ago

Promoted
New!

Michigan Licensed Health Information Analyst

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for a Health Information Management Analyst I - Document Imaging and QA.Key Responsibilities Perform quality assurance checks on imaged documents and ensure accurate indexing...Show moreLast updated: 8 hours ago

Promoted

Missouri Licensed Prior Authorization Rep

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for a Prior Authorization Representative in Revenue Cycle Management.Key Responsibilities Validate patient information, scheduled tests / surgeries, and insurance details to en...Show moreLast updated: 1 day ago

Promoted
New!

Arizona Licensed Authorization Representative

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for a PAS Pre-Service Authorization Representative to handle insurance authorization requests and verification. Key Responsibilities Obtain and complete insurance authorizatio...Show moreLast updated: 20 hours ago

Promoted

Licensed Physician Reviewer

VirtualVocationsCranston, Rhode Island, 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
New!

California Licensed Review Nurse

VirtualVocationsCranston, Rhode Island, United States

Full-time

A company is looking for a Pre-Service Review Nurse RN to work remotely in the Pacific or Mountain Time Zones.Key Responsibilities Conduct utilization management, including Prior Authorization Re...Show moreLast updated: 20 hours ago