RN Clinical Appeals Reviewer
VirtualVocationsSpringfield, Missouri, United States30+ 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 • Springfield, Missouri, United States
Related jobs 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 
Job Title : Psychometric Clinical Rater Location : Ozark, Missouri Type : Direct Hire Contractor Work Model : Onsite About the Role : The Psychometric Clinical Rater will be responsible for conducting a...Show moreLast updated: 5 days ago 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: 23 hours ago 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 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 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 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: 15 hours ago 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 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 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 A company is looking for an Inpatient Facility / HIMS Certified Medical Coder, Quality Associate.Key Responsibilities Provide guidance on coding and billing, ensuring compliance with guidelines Re...Show moreLast updated: 30+ days ago 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 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 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 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: 1 day ago 
We’re a Little Different.We bring to life a healing ministry through our compassionate care and exceptional service.Join us and discover why Modern Healthcare Magazine named us in its “...Show moreLast updated: 12 days ago 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 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
Prior Authorization Specialist
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
Psychometric Clinical Rater
JouléOzark, MO, USPermanent
- Promoted
Health Claims Examiner
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
Licensed Physician Reviewer
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
Michigan Licensed Clinical Document Specialist
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
Patient Intake Coordinator
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
- New!
South Dakota Licensed Clinical Documentation Specialist
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
Remote Medical Insurance Verifier
VirtualVocationsSpringfield, Missouri, United StatesRemote
Full-time
- Promoted
Medical Records Coordinator
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
Health Information Specialist I
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
Certified Inpatient Coder
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
Medical Records Specialist
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
Patient Access Specialist
VirtualVocationsSpringfield, Missouri, United StatesPart-time
- Promoted
Health Information Specialist
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
California Licensed Review Nurse
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
Certified Medical Assistant (Orthopedic Hospital-Ozark)
MercyOzark, MO, USFull-time
- Promoted
Pennsylvania Licensed Clinical Appeals Reviewer
VirtualVocationsSpringfield, Missouri, United StatesFull-time
- Promoted
South Carolina Licensed RN Reviewer
VirtualVocationsSpringfield, Missouri, United StatesFull-time