Talent.com
RN Clinical Appeals Specialist
RN Clinical Appeals SpecialistVirtualVocations • Jackson, Mississippi, United States
RN Clinical Appeals Specialist

RN Clinical Appeals Specialist

VirtualVocations • Jackson, Mississippi, United States
30+ days ago
Job type
  • Full-time
Job description

A company is looking for a Clinical Appeals RN - Remote.

Key Responsibilities

Perform initial assessments of appeals, medical records, and compliance with coverage criteria

Identify additional information needed to process appeals and adapt to changes in appeal types

Utilize clinical judgment and critical thinking to make decisions on administrative nurse level cases

Required Qualifications

Current, valid, and unrestricted RN licensure in the state of residence

2+ years of clinical experience in acute care or outpatient settings

1+ years of experience in Utilization Review or Medicaid / Medicare appeals

Understanding of billable services and claims in a managed care environment

Access to high-speed internet and ability to work 8-5 within the EST time zone

Create a job alert for this search

Clinical Specialist • Jackson, Mississippi, United States

Related jobs
Travel Labor & Delivery RN

Travel Labor & Delivery RN

Nightingale Nurses • Flowood, MS, US
Full-time
Nightingale Nurses is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Flowood, Mississippi.Job Description & Requirements. You may not realize it, but as an RN with real...Show more
Last updated: 30+ days ago • Promoted
Maryland Licensed Clinical Appeals Nurse

Maryland Licensed Clinical Appeals Nurse

VirtualVocations • Jackson, Mississippi, United States
Full-time
A company is looking for a Clinical Appeals Nurse (Remote).Key Responsibilities Investigates and analyzes written appeals and reconsideration requests, responding with detailed letters while adhe...Show more
Last updated: 2 days ago • Promoted
Clinical Application Specialist

Clinical Application Specialist

VirtualVocations • Jackson, Mississippi, United States
Full-time
A company is looking for a Clinical Application Specialist to oversee statistical programming activities and ensure the accuracy of clinical data sets. Key Responsibilities Lead statistical progra...Show more
Last updated: 1 day ago • Promoted
Tennessee Licensed Clinical Review Manager

Tennessee Licensed Clinical Review Manager

VirtualVocations • Jackson, Mississippi, United States
Full-time
A company is looking for a Clinical Review Manager to oversee medical reviews for utilization management.Key Responsibilities Initiate referrals for appropriate coordination of care Assist in co...Show more
Last updated: 9 days ago • Promoted
Travel Nurse RN - Cardiac Catheterization Lab - $2,060 per week in Flowood, MS

Travel Nurse RN - Cardiac Catheterization Lab - $2,060 per week in Flowood, MS

TravelNurseSource • Flowood, MS, US
Full-time
TravelNurseSource is working with Triage Staffing to find a qualified Cath Lab RN in Flowood, Mississippi, 39232!.Travel Nursing : Cath Lab Flowood, MS. Shift Details : 8H Days (7 : 30 AM-4 : 00 PM).Len...Show more
Last updated: 8 days ago • Promoted
Travel RN Case Manager, Discharge Planning

Travel RN Case Manager, Discharge Planning

Nightingale Nurses • Jackson, MS, US
Full-time
Nightingale Nurses is seeking a travel nurse RN Case Management for a travel nursing job in Jackson, Mississippi.Job Description & Requirements. You may not realize it, but as an RN with real wo...Show more
Last updated: 4 days ago • Promoted
Travel RN Case Manager, Discharge Planning

Travel RN Case Manager, Discharge Planning

American Medical Staffing • Jackson, MS, US
Full-time
American Medical Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Jackson, Mississippi.Job Description & Requirements. We’re living in the new normal.Lives...Show more
Last updated: 4 days ago • Promoted
Per Diem / PRN Nurse RN - Home Health

Per Diem / PRN Nurse RN - Home Health

AccentCare • Camden, MS, US
Full-time
AccentCare is seeking a per diem / prn nurse RN Home Health for a per diem / prn nursing job in Camden, Mississippi.Job Description & Requirements. Coverage Area : All of Madison County, Bentonia...Show more
Last updated: 8 days ago • Promoted
Behavioral Health Appeals Clinician

Behavioral Health Appeals Clinician

VirtualVocations • Jackson, Mississippi, United States
Full-time
A company is looking for a Clinical Review Clinician Appeals - Behavioral Health.Key Responsibilities Performs clinical reviews to resolve and process appeals by analyzing medical records and cli...Show more
Last updated: 2 days ago • Promoted
Travel RN Case Manager, Discharge Planning

Travel RN Case Manager, Discharge Planning

Care Career • Jackson, MS, US
Full-time
Care Career is seeking a travel nurse RN Case Management for a travel nursing job in Jackson, Mississippi.Job Description & Requirements. Case managers work to facilitate patient care by assessi...Show more
Last updated: 4 days ago • Promoted
Travel Nurse RN - Cardiovascular Operating Room - $2,787 per week in Columbus, MS

Travel Nurse RN - Cardiovascular Operating Room - $2,787 per week in Columbus, MS

TravelNurseSource • Jackson, Mississippi, US
Full-time
TravelNurseSource is working with Gifted Healthcare to find a qualified CVOR RN in Columbus, Mississippi, 39701!.The Gifted Healthcare Experience . Gifted Healthcare is an award-winning travel nursi...Show more
Last updated: 8 days ago • Promoted
Travel Registered Nurse - Cardiac Catheterization Lab - $2,206 per week in Flowood, MS

Travel Registered Nurse - Cardiac Catheterization Lab - $2,206 per week in Flowood, MS

TravelNurseSource • Flowood, MS, US
Full-time
TravelNurseSource is working with Openwork Health to find a qualified Cath Lab RN in Flowood, Mississippi, 39232!.Openwork Health Is Hiring! Let’s Chase Big Dreams—Together.We’re not your average t...Show more
Last updated: 8 days ago • Promoted
RN Clinical Documentation Consultant

RN Clinical Documentation Consultant

VirtualVocations • Jackson, Mississippi, United States
Full-time
A company is looking for a CDI Consultant to support clinical documentation improvement in a remote capacity.Key Responsibilities Review and evaluate medical record documentation for completeness...Show more
Last updated: 2 days ago • Promoted
Travel RN Case Manager, Discharge Planning

Travel RN Case Manager, Discharge Planning

LeaderStat • Jackson, MS, US
Full-time +1
LeaderStat is seeking a travel nurse RN Case Management for a travel nursing job in Jackson, Mississippi.Job Description & Requirements. The above pay package is an estimate, please contact our ...Show more
Last updated: 4 days ago • Promoted
Travel Nurse RN - Cardiac Catheterization Lab - $2,206 per week in Flowood, MS

Travel Nurse RN - Cardiac Catheterization Lab - $2,206 per week in Flowood, MS

TravelNurseSource • Flowood, MS, US
Full-time
TravelNurseSource is working with Openwork Health to find a qualified Cath Lab RN in Flowood, Mississippi, 39232!.Openwork Health Is Hiring! Let’s Chase Big Dreams—Together.We’re not your average t...Show more
Last updated: 8 days ago • Promoted
Clinical Application Specialist III

Clinical Application Specialist III

VirtualVocations • Jackson, Mississippi, United States
Full-time
A company is looking for a Clinical Application Specialist III.Key Responsibilities Lead statistical programming activities for development and maintenance of integrated clinical safety data sets...Show more
Last updated: 1 day ago • Promoted
North Carolina Licensed Case Manager, RN

North Carolina Licensed Case Manager, RN

VirtualVocations • Jackson, Mississippi, United States
Full-time
A company is looking for a Remote Case Manager.Key Responsibilities : Collaborate with a multidisciplinary healthcare team to monitor utilization patterns and facilitate appropriate care delivery ...Show more
Last updated: 30+ days ago • Promoted
Outpatient Registered Nurse - RN

Outpatient Registered Nurse - RN

Fresenius Medical Care • Canton, Mississippi, US
Full-time
At least 1 year of RN experience.Dialysis experienced is preferred but.The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP...Show more
Last updated: 30+ days ago • Promoted