Pennsylvania Licensed Clinical Appeals Reviewer
VirtualVocationsWashington, District of Columbia, United States1 day ago
Job type
- Full-time
Job description
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 billing code compliance
Engage with appellants, providers, and members to gather necessary information for case determination
Required Qualifications, Training, and Education
Bachelor's degree (BSN) required
3 or more years of experience in a related clinical setting
Current and unrestricted Registered Nurse (RN) licensure
Working knowledge of InterQual criteria preferred
Proficiency in utilizing Electronic Medical Records (EMRs) and MS Office
Create a job alert for this search
Clinical Reviewer • Washington, District of Columbia, United States
Related jobs
Health Care Counsel / Senior Counsel.Legal Services – Health Care & Life Sciences.Attorney – Health Care & FCA Litigation.
Join a nationally ranked Health Care & Life Science...Show moreLast updated: 30+ days ago
Sands Anderson, a full-service, mid-sized law firm in the Mid-Atlantic region, is expanding in key practice areas.Our firm specializes in Government representation, Business representation and Liti...Show moreLast updated: 30+ days ago
Policy Processing Representative.The Policy Processing Representative is responsible for efficiently processing policy-related transactions, ensuring accuracy and compliance with company policies a...Show moreLast updated: 30+ days ago
Bilingual Dispute Resolution Specialist I.Our client is seeking a Bilingual Dispute Resolution Specialist I to join their growing team.
This position begins as a customer supportfocused role, where ...Show moreLast updated: 30+ days ago
Job Tittle : Legal Clerk I & II Work • • • • • - Washington, DC 20005 (Onsite) • • • • • Long term Contract Engagement • • • • • The role requires availability to work five days a week on-site at a client ...Show moreLast updated: 29 days ago
Healthcare Attorney (Remote, As-Needed).Headquartered in California and serving clients nationwide, we provide innovative solutions to healthcare organizations including hospitals, community clinic...Show moreLast updated: 30+ days ago
Associate Attorney – Litigation.Direct Counsel is representing an.This role offers the opportunity to work on complex litigation matters for clients across a variety of industries in a collab...Show moreLast updated: 30+ days ago
Careers Advancement Opportunities.In this role, you will provide legal counsel, perform legal research, draft documents, and update and maintain files.
Much of your time will be spent navigating sen...Show moreLast updated: 30+ days ago
Key Risk Workers' Compensation Claims Representative III.With over 35 years of proven expertise in the workers' compensation industry, Key Risk delivers innovative and responsive solutions that pro...Show moreLast updated: 30+ days ago
Armada - pay our members claims! The Claims Analyst is responsible for reviewing portal entry claims, conducting error correction and quality control reviews, as well as final adjudication of paper...Show moreLast updated: 8 days ago
Price Benowitz LLP is a rapidly growing law firm headquartered in Washington, D.Maryland, Virginia, and beyond.Our dedicated attorneys and staff are committed to providing high-quality legal servic...Show moreLast updated: 28 days ago
The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, un...Show moreLast updated: 30+ days ago
Job Description Job Opening : Patient Accounts Representative / Accounts Receivable .We are seeking a skilled and detail-oriented Patient Accounts Representative / Accounts Receivable professional to jo...Show moreLast updated: 7 days ago
The Legal Intake Specialist plays a crucial role in the Intake Department, managing the entire lead process from initial contact to client sign-up for all incoming prospective clients with new case...Show moreLast updated: 12 days ago
Are you a collateral risk management professional with deep knowledge of property, casualty and flood insurance markets? If you want to make an impact in the U.
Single Family team! Apply now to lear...Show moreLast updated: 30+ days ago
Provider Contracting Lead Analyst.Work Location : Supports our Virginia market - Preferred candidate to live in either Richmond or McLean, VA area.
Hybrid position - will need to work in the office o...Show moreLast updated: 30+ days ago
This position is in the Clerk's Office of the United States Judicial Panel on Multidistrict Litigation (Panel).The incumbent reports to the Operations Supervisor.
The incumbent manages the progressi...Show moreLast updated: 27 days ago The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, un...Show moreLast updated: 12 days ago 
Lawyers On Demand is currently seeking skilled applicants on behalf of a global law firm in Northern Virginia to fill an opening as an Immigration Administrative Specialist.This role is equivalent ...Show moreLast updated: 1 day ago
Senior Analytics Pricing Consultant.Equifax is where you can power your possible.If you want to achieve your true potential, chart new paths, develop new skills, collaborate with bright minds, and ...Show moreLast updated: 30+ days ago
- Promoted
Senior Counsel - Healthcare
K2 AscendWashington, DC, USFull-time
- Promoted
Experienced Attorney - Any Office
Sands AndersonManassas, VA, USFull-time
- Promoted
Policy Processing Representative
Ryan SpecialtyCockeysville, MD, USFull-time
- Promoted
Bilingual Dispute Resolution Specialist I
Addison GroupReston, VA, USFull-time
- Promoted
Legal Clerk I & II
Ark SolutionsWashington, DC, United StatesFull-time
- Promoted
Healthcare Attorney
Vivo HealthStaffArlington, VA, USFull-time
- Promoted
Litigation Associate (Jr. to mid level) - Northern Virginia
Direct CounselMcLean, VA, USFull-time
- Promoted
Family Attorney
Immigrants First PLLCManassas, VA, USFull-time
- Promoted
Claims Representative III
W.R. BerkleyTowson, MD, USFull-time
- Promoted
Claims Analyst
ARMADACARELutherville-Timonium, MD, USFull-time
- Promoted
Workers' Compensation Attorney
Price Benowitz LLPShady Grove, MD, USFull-time
- Promoted
Claims Specialist
CorVelBaltimore, MD, USFull-time
- Promoted
Medical Collector
Chesapeake Oncology Hematology AssociatesDeale, MD, United StatesFull-time
- Promoted
Law Firm Intake Specialist
WGK Personal Injury LawyersBaltimore, MD, USFull-time
- Promoted
Insurance Policy Collateral Risk, Senior
Freddie MacMc Lean, VA, USFull-time
- Promoted
Healthcare - Provider Contract Negotiator - Richmond / McLean, VA market - Hybrid
CignaFalls Church, VA, USFull-time
- Promoted
Case Administrator I / II
US Government JobsWashington, DC, USFull-time
- Promoted
Claims Specialist - Indemnity
CorVelBaltimore, MD, USFull-time
- Promoted
Immigration Legal Secretary
Lawyers On Demand, a Consilio CompanyMcLean, VA, USFull-time
- Promoted
Consent
EquifaxWashington, DC, USFull-time