Talent.com
RN Clinical Appeals Reviewer

RN Clinical Appeals Reviewer

VirtualVocationsGarland, Texas, 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 • Garland, Texas, United States

Related jobs
  • Promoted
  • New!
Pennsylvania Licensed Clinical Appeals Reviewer

Pennsylvania Licensed Clinical Appeals Reviewer

VirtualVocationsGrand Prairie, Texas, 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: 20 hours ago
  • Promoted
Patient Screening Specialist

Patient Screening Specialist

VirtualVocationsGarland, Texas, United States
Full-time
A company is looking for a Patient Screening Specialist to efficiently screen, schedule, and guide patients through the clinical trial process. Key Responsibilities Conduct phone screenings to ass...Show moreLast updated: 2 days ago
  • Promoted
Health Information Analyst

Health Information Analyst

VirtualVocationsMesquite, Texas, 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
Prior Authorization Specialist

Prior Authorization Specialist

VirtualVocationsGarland, Texas, 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
  • New!
South Carolina Licensed RN Reviewer

South Carolina Licensed RN Reviewer

VirtualVocationsIrving, Texas, 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: 16 hours ago
  • Promoted
  • New!
Health Claims Examiner

Health Claims Examiner

VirtualVocationsPlano, Texas, United States
Full-time
A company is looking for a Health Claims Examiner I.Key Responsibilities Review medical documents to ensure completeness and validity for claim adjudication Determine covered services and calcul...Show moreLast updated: 4 hours ago
  • Promoted
Pre-Certification Coordinator

Pre-Certification Coordinator

VirtualVocationsGarland, Texas, United States
Full-time
A company is looking for a Pre-Certification Coordinator I (Remote) - Surgery.Key Responsibilities Initiates and facilitates the pre-determination process with insurance companies Maintains dail...Show moreLast updated: 30+ days ago
  • Promoted
Licensed RN Clinical Appeals Reviewer

Licensed RN Clinical Appeals Reviewer

VirtualVocationsMesquite, Texas, 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
Remote Medical Records Processor

Remote Medical Records Processor

VirtualVocationsArlington, Texas, United States
Remote
Full-time
A company is looking for a REMOTE Medical Records Processor.Key Responsibilities Process medical record requests by handling calls from patients, insurance companies, and attorneys Document info...Show moreLast updated: 2 days ago
  • Promoted
  • New!
Missouri Licensed Prior Authorization Rep

Missouri Licensed Prior Authorization Rep

VirtualVocationsMesquite, Texas, 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: 20 hours ago
  • Promoted
  • New!
California Licensed Review Nurse

California Licensed Review Nurse

VirtualVocationsArlington, Texas, 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: 6 hours ago
  • Promoted
Remote Medical Insurance Verifier

Remote Medical Insurance Verifier

VirtualVocationsCarrollton, Texas, 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: 1 day ago
  • Promoted
  • New!
Utilization Review Nurse Health Plans-Hp Utilization Mgmt

Utilization Review Nurse Health Plans-Hp Utilization Mgmt

Christus HealthIrving, TX, US
Full-time
The Utilization Review Nurse is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services.This nurse is res...Show moreLast updated: 15 hours ago
  • Promoted
  • New!
Licensed Physician Reviewer

Licensed Physician Reviewer

VirtualVocationsIrving, Texas, 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: 16 hours ago
  • Promoted
Health Information Specialist I

Health Information Specialist I

VirtualVocationsGarland, Texas, 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: 1 day ago
  • Promoted
Michigan Licensed Clinical Document Specialist

Michigan Licensed Clinical Document Specialist

VirtualVocationsCarrollton, Texas, 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: 1 day ago
  • Promoted
Patient Intake Coordinator

Patient Intake Coordinator

VirtualVocationsGarland, Texas, 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
RN Clinical Appeals Reviewer

RN Clinical Appeals Reviewer

VirtualVocationsPlano, Texas, United States
Full-time
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 C...Show moreLast updated: 30+ days ago
  • Promoted
Patient Access Coordinator

Patient Access Coordinator

VirtualVocationsGarland, Texas, United States
Full-time
A company is looking for a Patient Access Scheduling Coordinator.Key Responsibilities Schedule routine and complex primary care and specialty appointments Perform full patient registration and v...Show moreLast updated: 30+ days ago
  • Promoted
Care Review Processor

Care Review Processor

VirtualVocationsArlington, Texas, United States
Full-time
A company is looking for a Care Review Processor (Remote) PST Hours.Key Responsibilities Provides telephone, clerical, and data entry support for the care review team Handles authorization reque...Show moreLast updated: 30+ days ago