Talent.com
RN Clinical Appeals Reviewer

RN Clinical Appeals Reviewer

VirtualVocationsJamaica, New York, 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 • Jamaica, New York, United States

Related jobs
  • Promoted
  • New!
South Carolina Licensed RN Reviewer

South Carolina Licensed RN Reviewer

VirtualVocationsBronx, New York, 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: 14 hours ago
  • Promoted
  • New!
Licensed Physician Reviewer

Licensed Physician Reviewer

VirtualVocationsJackson Heights, New York, 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: 14 hours ago
  • Promoted
Pre-Certification Coordinator

Pre-Certification Coordinator

VirtualVocationsFlushing, New York, 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
Remote Medical Records Processor

Remote Medical Records Processor

VirtualVocationsFlushing, New York, 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

VirtualVocationsFlushing, New York, 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: 18 hours ago
  • Promoted
Medical Claims Processor

Medical Claims Processor

VirtualVocationsJamaica, New York, United States
Full-time
A company is looking for a Healthcare & Insurance Operations Processing Senior Representative.Key Responsibilities Process professional claim forms submitted by providers and review policies ...Show moreLast updated: 30+ days ago
  • Promoted
Area Lead Health Information Specialist (Hybrid)

Area Lead Health Information Specialist (Hybrid)

DatavantHackensack, NJ, US
Full-time
Datavant is a data platform company and the world's leader in health data exchange.Our vision is that every healthcare decision is powered by the right data, at the right time, in the right for...Show moreLast updated: 4 days ago
  • Promoted
  • New!
Pennsylvania Licensed Clinical Appeals Reviewer

Pennsylvania Licensed Clinical Appeals Reviewer

VirtualVocationsBrooklyn, New York, 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: 18 hours ago
  • Promoted
  • New!
Health Claims Examiner

Health Claims Examiner

VirtualVocationsStaten Island, New York, 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: 2 hours ago
  • Promoted
Health Information Specialist I

Health Information Specialist I

VirtualVocationsJamaica, New York, 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
Health Information Analyst

Health Information Analyst

VirtualVocationsFlushing, New York, 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

Licensed RN Clinical Appeals Reviewer

VirtualVocationsBronx, New York, 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
  • New!
California Licensed Review Nurse

California Licensed Review Nurse

VirtualVocationsYonkers, New York, 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: 4 hours ago
  • Promoted
Michigan Licensed Clinical Document Specialist

Michigan Licensed Clinical Document Specialist

VirtualVocationsAstoria, New York, 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 Screening Specialist

Patient Screening Specialist

VirtualVocationsBrooklyn, New York, 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
RN Clinical Appeals Reviewer

RN Clinical Appeals Reviewer

VirtualVocationsFlushing, New York, 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
Certified Medical Coder III

Certified Medical Coder III

VirtualVocationsBronx, New York, 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: 30+ days ago
  • Promoted
Certified Medical Coder - IL

Certified Medical Coder - IL

VirtualVocationsYonkers, New York, 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: 1 day ago
  • Promoted
  • New!
Surgical Authorization Specialist

Surgical Authorization Specialist

Progressive Spine and Orthopaedics LLCClifton, New Jersey, United States, 07011
Full-time
Quick Apply
JOB TITLE : Surgical Authorization Specialist SUMMARY : The Surgical Authorization Specialist at Progressive Spine & Orthopaedics is responsible for securing and managing surgical authorizations, wi...Show moreLast updated: 17 hours ago
  • Promoted
Remote Medical Insurance Verifier

Remote Medical Insurance Verifier

VirtualVocationsFlushing, New York, 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