Talent.com
Wisconsin Licensed Clinical Appeals RN
Wisconsin Licensed Clinical Appeals RNVirtualVocations • Norcross, Georgia, United States
Wisconsin Licensed Clinical Appeals RN

Wisconsin Licensed Clinical Appeals RN

VirtualVocations • Norcross, Georgia, United States
30+ days ago
Job type
  • Full-time
Job description

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 State guidelines

Accurately document determinations and interpret Plan language

Required Qualifications :

Active, unrestricted RN licensure in the state of residence

5+ years of RN experience in an acute care inpatient facility

Intermediate Microsoft skills (MS Word and Outlook)

Ability to work independently with self-discipline

Access to secure high-speed internet in a designated workspace

Create a job alert for this search

Rn • Norcross, Georgia, United States

Related jobs
RN Clinical Review Clinician

RN Clinical Review Clinician

VirtualVocations • Atlanta, Georgia, United States
Full-time
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
Last updated: 30+ days ago • Promoted
Licensed Clinical Case Manager

Licensed Clinical Case Manager

VirtualVocations • Marietta, Georgia, United States
Full-time
A company is looking for a Clinical Case Manager Behavioral Health to work from home.Key Responsibilities Facilitate member physical health and behavioral healthcare through assessment, care plan...Show more
Last updated: 3 days ago • Promoted
Texas Licensed Clinical Manager

Texas Licensed Clinical Manager

VirtualVocations • Norcross, Georgia, United States
Full-time
A company is looking for a Senior Manager, Clinical to join their Case Management team.Key Responsibilities Review and maintain policies and procedures to meet regulatory, accreditation, and orga...Show more
Last updated: 30+ days ago • Promoted
California Licensed RN Case Manager

California Licensed RN Case Manager

VirtualVocations • Marietta, Georgia, United States
Full-time
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
Last updated: 30+ days ago • Promoted
Virginia Licensed RN Clinical Appeals

Virginia Licensed RN Clinical Appeals

VirtualVocations • Atlanta, Georgia, United States
Full-time
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
Last updated: 30+ days ago • Promoted
Travel Nurse RN - Stepdown

Travel Nurse RN - Stepdown

Titan Medical Group • Rydal, GA, US
Full-time
WHEN YOU WORK FOR US, WE WORK FOR YOU\n.With Titan Medical, you gain access to thousands of travel nursing and allied health jobs across the country. You also get unmatched service.From the moment y...Show more
Last updated: 1 day ago • Promoted
State Licensed RN Medical Reviewer

State Licensed RN Medical Reviewer

VirtualVocations • Marietta, Georgia, United States
Full-time
A company is looking for a Remote RN - Medical Claims Reviewer.Key Responsibilities Review medically complex claims, pre-authorization requests, appeals, and fraud / abuse referrals Assess payment...Show more
Last updated: 3 hours ago • Promoted • New!
Connecticut Licensed Claims Examiner

Connecticut Licensed Claims Examiner

VirtualVocations • Decatur, Georgia, United States
Full-time
A company is looking for a Workers Compensation Claims Examiner for MA, CT, NH, and RI jurisdictions.Key Responsibilities Analyze and process claims to achieve timely resolutions through investig...Show more
Last updated: 3 days ago • Promoted
Hawaii Licensed Utilization Review Clinician

Hawaii Licensed Utilization Review Clinician

VirtualVocations • Atlanta, Georgia, United States
Full-time
A company is looking for a Utilization Review Clinician - Behavioral Health.Key Responsibilities Evaluates treatment for mental health and substance abuse to ensure medical appropriateness Perfo...Show more
Last updated: 4 days ago • Promoted
Florida Licensed Clinical Therapist

Florida Licensed Clinical Therapist

VirtualVocations • Norcross, Georgia, United States
Full-time
A company is looking for a Licensed Clinical Therapist (LCSW / LMHC / LMFT) for an Adult Intensive Outpatient Virtual Group. Key Responsibilities Provide virtual IOP remote group coverage via video co...Show more
Last updated: 30+ days ago • Promoted
Experienced RN Hiring Event 11 / 20 / 25 | Wellstar Cobb

Experienced RN Hiring Event 11 / 20 / 25 | Wellstar Cobb

Wellstar Health Systems, Inc. • Austell, GA, US
Full-time
How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission i...Show more
Last updated: 4 days ago • Promoted
Arizona Licensed Clinical Supervisor

Arizona Licensed Clinical Supervisor

VirtualVocations • Atlanta, Georgia, United States
Full-time
A company is looking for a Supervisor, Clinical Data Acquisition (Remote).Key Responsibilities Supervises staff involved in HEDIS performance measurement and quality reporting Implements and ove...Show more
Last updated: 2 days ago • Promoted
Travel Nurse - RN - OR - Operating Room - $2118.28 / Week - Hiring Now

Travel Nurse - RN - OR - Operating Room - $2118.28 / Week - Hiring Now

Medical Solutions • Douglasville, GA, US
Full-time
Medical Solutions is seeking an experienced Operating Room Registered Nurse for an exciting Travel Nursing job in Douglasville, GA. Shift : 4x10 hr days Start Date : ASAP Duration : 13 weeks Pay : $2118...Show more
Last updated: 1 day ago • Promoted
Travel Registered Nurse (RN) - Telemetry - $1,529 per week in Canton, GA

Travel Registered Nurse (RN) - Telemetry - $1,529 per week in Canton, GA

TravelNurseSource • Canton, GA, US
Full-time
TravelNurseSource is working with TRS Healthcare to find a qualified Telemetry RN in Canton, Georgia, 30115!.Registered Nurse - Telemetry Unit. TRS Healthcare is seeking a Registered Nurse who is li...Show more
Last updated: 6 days ago • Promoted
ObGyn

ObGyn

CompHealth • Canton, Georgia, US
Full-time
ObGyn physician job in Georgia : Whether you are searching for a position in your area or in another state, we have professionals to help you achieve your goals through our relationships with facil...Show more
Last updated: 30+ days ago • Promoted
California Licensed Clinical Therapist

California Licensed Clinical Therapist

VirtualVocations • Atlanta, Georgia, United States
Full-time
A company is looking for a Licensed Clinical Therapist for Telehealth services focused on adult intensive outpatient programs. Key Responsibilities Provide virtual IOP coverage via video conferenc...Show more
Last updated: 30+ days ago • Promoted
Licensed Utilization Review Clinician

Licensed Utilization Review Clinician

VirtualVocations • Decatur, Georgia, United States
Full-time
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
Last updated: 30+ days ago • Promoted
LPC Associate - Full Time Hybrid

LPC Associate - Full Time Hybrid

Thriveworks • Cumming, GA, US
Full-time
Thriveworks is currently seeking provisionally licensed individuals pursuing Georgia Licensure as a.This role is eligible for a $7,500 ramp stipend for clinicians offering 25+ hours of availab...Show more
Last updated: 1 day ago • Promoted