Talent.com
Wisconsin Licensed Clinical Appeals RN
Wisconsin Licensed Clinical Appeals RNVirtualVocations • Newark, New Jersey, United States
Wisconsin Licensed Clinical Appeals RN

Wisconsin Licensed Clinical Appeals RN

VirtualVocations • Newark, New Jersey, 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 • Newark, New Jersey, United States

Related jobs
Wisconsin Licensed Clinical Appeals RN

Wisconsin Licensed Clinical Appeals RN

VirtualVocations • Astoria, New York, United States
Full-time
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 Stat...Show more
Last updated: 30+ days ago • Promoted
Licensed Utilization Review Clinician

Licensed Utilization Review Clinician

VirtualVocations • Bronx, New York, 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
Florida Licensed Clinical Therapist

Florida Licensed Clinical Therapist

VirtualVocations • Astoria, New York, 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
Arizona Licensed Clinical Service Representative

Arizona Licensed Clinical Service Representative

VirtualVocations • Astoria, New York, United States
Full-time
A company is looking for a Clinical Service Representative to provide phone assistance and support for prior authorization processes. Key Responsibilities Handle inbound calls from providers, phar...Show more
Last updated: 19 days ago • Promoted
Virginia Licensed RN Clinical Appeals

Virginia Licensed RN Clinical Appeals

VirtualVocations • Astoria, New York, 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: 19 days ago • Promoted
RN

RN

Fresenius Medical Care • New Brunswick, NJ, US
Full-time
The professional registered nurse.Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 criteria or attained through advancement from CAP 1. This position is accountable and res...Show more
Last updated: 1 day ago • Promoted
Licensed Clinical Case Manager

Licensed Clinical Case Manager

VirtualVocations • Astoria, New York, 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: 23 days ago • Promoted
State Licensed RN Medical Reviewer

State Licensed RN Medical Reviewer

VirtualVocations • New York, New York, 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: less than 1 hour ago • Promoted • New!
Arizona Licensed Clinical Supervisor

Arizona Licensed Clinical Supervisor

VirtualVocations • New York, New York, 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
New York Licensed Clinical Supervisor

New York Licensed Clinical Supervisor

VirtualVocations • New York, New York, United States
Full-time
A company is looking for a Supervisor, Clinical Grievance and Appeals.Key Responsibilities Supervise nurses in the clinical Appeals and Grievance department, ensuring compliance with state / federa...Show more
Last updated: 3 days ago • Promoted
California Licensed RN Case Manager

California Licensed RN Case Manager

VirtualVocations • Bronx, New York, 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
Connecticut Licensed Claims Examiner

Connecticut Licensed Claims Examiner

VirtualVocations • Elizabeth, New Jersey, 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
RN Clinical Review Clinician

RN Clinical Review Clinician

VirtualVocations • Bronx, New York, 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
California Licensed Clinical Therapist

California Licensed Clinical Therapist

VirtualVocations • New York, New York, 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
Texas Licensed Care Review Clinician

Texas Licensed Care Review Clinician

VirtualVocations • New York, New York, United States
Full-time
A company is looking for a Care Review Clinician (RN) for Prior Authorization.Key Responsibilities Assess services for members to ensure optimum outcomes and compliance with regulations Analyze ...Show more
Last updated: 4 days ago • Promoted
Travel MedSurg RN Job in Morristown, New Jersey

Travel MedSurg RN Job in Morristown, New Jersey

Gifted Healthcare • Bridgewater, NJ, US
Full-time
MedSurg RNs provide bedside care for a variety of patients and execute individualized patient assessments to create an individualized plan of care. MedSurg RNs prepare equipment and assist physician...Show more
Last updated: 30+ days ago • Promoted
Hawaii Licensed Utilization Review Clinician

Hawaii Licensed Utilization Review Clinician

VirtualVocations • Astoria, New York, 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 hours ago • Promoted • New!
Texas Licensed Clinical Manager

Texas Licensed Clinical Manager

VirtualVocations • Elizabeth, New Jersey, 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