Pennsylvania Licensed Clinical Appeals Reviewer
VirtualVocationsLouisville, Kentucky, United States20 hours 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 • Louisville, Kentucky, United States
Related jobs
Responsible for obtaining and tracking authorization for all patients for whom their insurance requires pre-authorization, and ensuring the agency has the authorization required to bill for service...Show moreLast updated: 30+ days ago
Talis Group’s client is an award-winning, full-service law firm located in Louisville.They are looking to hire a.This role will prepare & process billing invoices from pre-stage to final ...Show moreLast updated: 30+ days ago
Evaluation and Referral / Intake Coordinator - PRN all shifts.Training for this position will be during the weekdays.The Brook - KMI is a 98-bed hospital offering a full continuum of inpatient, exte...Show moreLast updated: 12 days ago
Blu Solutions was founded in 2012 to help specialty medical practices manage the complex workflow associated with high-cost infusion and injection treatments.
Simply put, our solution gets patients ...Show moreLast updated: 30+ days ago
Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc.
Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...Show moreLast updated: 13 days ago
Court Reporter Job Duties : In addition to the above job responsibilities, a court reporter documents files with court exhibits and indexes.
files notes taken in court.Preserves notes as required by...Show moreLast updated: 13 hours ago
Locations : Wisconsin, Indiana, Kentucky.Virtual : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility ...Show moreLast updated: 30+ days ago
Since 1982 Wellspring has championed mental health recovery in Louisville.Serving some of the most vulnerable people in our community, Wellspring is a pillar of hope.
We support adults in building h...Show moreLast updated: 30+ days ago
The purpose of the Recovery Associate is to uphold the store's general look and arrangement.The primary emphasis lies in guaranteeing the correct return of merchandise to the sales floor, maintaini...Show moreLast updated: 30+ days ago
A career at Auto-Owners is challenging and rewarding.Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.We offer a me...Show moreLast updated: 30+ days ago
As an Associate in Stoll Keenon Ogden’s Business Litigation Strategic Business Unit, you will have the opportunity to work in a complex and ever-changing business sector.In this role, Associa...Show moreLast updated: 30+ days ago
Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE / COE, Auto, and Homeowners.
SIU experience is highly desired, but not require...Show moreLast updated: 30+ days ago
Analyze and process policy changes, reinstatements and cancellations via multiple data entry systems.Requests are received from agents, insured or State Office personnel.
Ensure accurate and complet...Show moreLast updated: 30+ days ago
Complex Claims Adjuster-Warranty.At AIG, we are reimagining the way we help customers to manage risk.Join us as a Complex Claims Adjuster-Warranty to play your part in that transformation.It's an o...Show moreLast updated: 30+ days ago
Public Safety Account Executive.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 make...Show moreLast updated: 30+ days ago
Medicaid Offsets And Special Care Insurance Policies Assistant.To process, file and administer Medicaid offsets and provide Special Care Insurance Policies (SCIP) department assistance.Responsible ...Show moreLast updated: 30+ days ago
Beacon Hill was founded to set a new standard in search, career placement and flexible staffing.Job Description : (30 days training in office in Louisville, KY then 100% virtual after) The Claims An...Show moreLast updated: 8 hours ago
Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the countr...Show moreLast updated: 30+ days ago A well-established law firm is seeking a skilled Legal Secretary to provide direct support to an attorney focused on commercial real estate closings.
This role requires a high degree of accuracy, st...Show moreLast updated: 30+ days ago 
Court Reporter Job Duties : In addition to the above job responsibilities, a court reporter do...Show moreLast updated: 30+ days ago
- Promoted
Authorization Specialist
BrightSpring Health ServicesLouisville, KY, USFull-time
Legal Billing Specialist
Talis Group, Inc.Louisville, Kentucky, United StatesFull-time +1
Quick Apply
- Promoted
Evaluation and Referral / Intake Coordinator - PRN
Universal Health Services, Inc.Louisville, KY, United StatesFull-time
- Promoted
Insurance Verification Specialist I
EBlu Solutions, Inc.Louisville, KY, USFull-time
- Promoted
Workers' Compensation Claims Adjuster
Argonaut Management Services, IncLouisville, KY, United StatesFull-time
- New!
Court Reporter
MediabistroAustin, IN, United StatesFull-time
- Promoted
Subrogation Analyst
Elevance HealthLouisville, KY, USFull-time
Assertive Community Treatment (ACT) Targeted Case Manager (TCM)
WellspringLouisville, KY, USFull-time
Quick Apply
- Promoted
Recovery Associate
Rural KingShelbyville, KY, USFull-time
- Promoted
Field Claim Representative
Auto-Owners InsuranceLouisville, KY, USFull-time
- Promoted
Associate-Litigation
Stoll Keenon Ogden PLLCLouisville, KY, USFull-time
- Promoted
Claims Investigator - Experienced
Command InvestigationsLouisville, KY, USFull-time
- Promoted
Policy Processor I
Kentucky Farm BureauLouisville, KY, USPart-time
- Promoted
Complex Claims Adjuster-Warranty
AIGJeffersonville, IN, USFull-time
- Promoted
Consent
EquifaxLouisville, KY, USFull-time
- Promoted
Medicaid Offset Specialist
360careLouisville, KY, USFull-time
- Promoted
- New!
Claims Analyst (remote)
USA JobsLouisville, KY, USRemote
Full-time
- Promoted
Subrogation Analyst - Liability Recovery Unit (LRU)
The Rawlings GroupLa Grange, KY, USFull-time
Legal Secretary
Talis Group, Inc.Louisville, Kentucky, United StatesFull-time
Quick Apply
- Promoted
Court Reporter
TradeJobsWorkForce47102 Austin, IN, USFull-time