Pennsylvania Licensed Clinical Appeals Reviewer
VirtualVocationsVirginia Beach, Virginia, 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 • Virginia Beach, Virginia, United States
Related jobs
Reviewers for the Department of Homeland Security (DHS) Background Investigation's Program.Reviewers work with investigators to complete and submit background investigation interviews and record ch...Show moreLast updated: 12 days ago
ProSidian is a Management and Operations Consulting Services Firm focusing on providing value to clients through tailored solutions based on industry leading practices.
ProSidian services focus on t...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
Litigation Attorney (Virginia) Turnbull Law Group, LLC.Turnbull Law Group, LLC is hiring a litigation attorney with 1-4 years of experience to join our team.
This is a work-from-home position that r...Show moreLast updated: 30+ days ago
This position requires the candidate to be fully licensed or currently under supervision of a licensed clinician (LCSW, LPC, or licensed psychologist).
The Clinical assessor is responsible for condu...Show moreLast updated: 21 hours ago
Responsibilities may include a portion of all of these areas : .Client Intake Conduct client intake by gathering initial information and documentation.
Provide professional, courteous communication to...Show moreLast updated: 25 days ago
The Liability Analyst reports to the Liability Manager and is responsible for managing and optimizing a portfolio of general and auto liability claims to reduce costs and improve outcomes.The succe...Show moreLast updated: 30+ days ago
WhitbeckBeglis, PLLC, a dynamic and client-focused law firm, is seeking a dedicated Family Law Attorney to join our team in Virginia Beach, Va.
Our firm is committed to providing top-tier legal serv...Show moreLast updated: 30+ days ago
Duties may include, but are not limited to : .Receive new losses and verifies accuracy of information via coverage.Register new loss information on system.
Perform all file updates on system as direct...Show moreLast updated: 2 days ago
As Physician Reviewer / Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims.The Physician Reviewer...Show moreLast updated: 30+ days ago
Local Infusion is a venture-backed healthcare company shaping the way care is delivered to patients with chronic autoimmune disease on specialty infusion medications.
Our focus on patient experience...Show moreLast updated: 30+ days ago
Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 5 days ago
The Executive Assistant to the Legal Team provides high-level, confidential administrative support.This position will be privy to confidential information and as such, requires diplomacy and discre...Show moreLast updated: 12 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: 18 days ago
Focus on the core content of the job post, removing all extra metadata, navigation mentions, and redundant headers.Keep the formatting beautiful and high signal to noise ratio.Show moreLast updated: 7 days ago Executive Assistant To The Legal Team.The Executive Assistant to the Legal Team provides high-level, confidential administrative support including duties ranging from administrative, project-based,...Show moreLast updated: 24 days ago 
Opening Date : 2 September 2025 Pay Plan / Series / Pay Band : NF-0343-04.Closing Date : Until Filled Work Schedule : Full Time.
Position : MWR Program Analyst Salary : $50,000-$73,000 Annually DOE •.Who May A...Show moreLast updated: 30+ days ago
By joining Sedgwick, you'll be part of something truly meaningful.It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected.
We invite you to grow your c...Show moreLast updated: 19 days ago
Patient Registration Coordinator.Behavioral Health Group (BHG) is the largest network of Joint Commission-accredited treatment centers and the leading provider of opioid addiction treatment service...Show moreLast updated: 13 days ago
The Executive Assistant to the Legal Team provides high-level, confidential administrative support.This position will be privy to confidential information and as such, requires diplomacy and discre...Show moreLast updated: 8 days ago
- Promoted
Case Reviewer
Clearance JobsVirginia Beach, VA, USFull-time
ProSidian Consulting, LLC is hiring : Court Reporter - Chesapeake, Virginia (CRS0
MediabistroChesapeake, VA, United StatesFull-time
- Promoted
Experienced Attorney - Any Office
Sands AndersonVirginia Beach, VA, USFull-time
- Promoted
Remote Litigation Attorney
Turnbull Law GroupVirginia Beach, VA, USRemote
Full-time
- Promoted
- New!
Full Time Clinical Assessor
Milestone LLCPortsmouth, VA, USFull-time
Paralegal (Virginia Beach)
Hanger LawVirginia Beach, VA, USFull-time
Quick Apply
- Promoted
Liability Analyst
Family DollarChesapeake, VA, USFull-time
- Promoted
Family Law Attorney
WHITBECKBEGLIS PLLCVirginia Beach, VA, USFull-time
- Promoted
Claim Assistant-Chesapeake, VA
StaffingChesapeake, VA, USFull-time
- Promoted
Neurology- Independent Medical Examiner (IME)
Dane Street, LLCChesapeake, VA, USFull-time
- Promoted
Intake Coordinator
Local InfusionNewport News, VA, USFull-time
- Promoted
Border Patrol Agent
U.S. Customs and Border ProtectionNassawadox, VA, USFull-time
- Promoted
Executive Legal Administrator
Family DollarChesapeake, VA, USFull-time
- Promoted
Claims Specialist
CorVelVirginia Beach, VA, USFull-time
- Promoted
Claim Specialist
ChubbChesapeake, VA, USFull-time
- Promoted
Executive Administrator, Legal
Family DollarChesapeake, VA, USFull-time
- Promoted
MWR Program Analyst FT- 6420
Coast Guard Community Services CommandChesapeake, VA, USFull-time +1
- Promoted
Claims Representative - Auto
SedgwickVirginia Beach, VA, USFull-time
- Promoted
Patient Registration Coordinator
Behavioral Health GroupVirginia Beach, VA, USFull-time
- Promoted
Executive Legal Administrator (Chesapeake)
Family DollarChesapeake, VA, USPart-time