Clinical Appeals Nurse

**Job Summary**The Clinical Appeals Nurse Specialist plays a crucial role in handling appeals that require clinical input or interpretation, ensuring a comprehensive understanding of medical necessity software and payer policy requirements.Responsibilities:Compose clear and concise clinical appeal letters to send to payers for denial reconsiderations,...

**Job Overview:**The Clinical Appeals Specialist plays a crucial role in handling complex appeals that require clinical input and interpretation. This position is responsible for composing compelling appeal letters to send to payers, ensuring thorough medical summaries are presented within each appeal.Main Responsibilities:Compose clinical appeal letters...

**Clinical Appeals Nurse Role at Auxis:**We are looking for a dedicated and detail-oriented Clinical Appeals Nurse to handle complex appeals requiring clinical input and interpretation. As a key member of our team, you will be responsible for composing compelling appeal letters and presenting concise medical summaries within each appeal.Main...

**About Auxis and the Role:**Auxis is seeking a skilled Clinical Appeals Specialist to join their team. As a key member of the organization, this individual will be responsible for handling appeals requiring clinical input or interpretation.Key Responsibilities:Compose appeal letters to payers using various sources of informationPresentation of clear and...

Join a Diverse Health Services Group in the Cruise IndustryWe are seeking over 50 nurses to provide quality healthcare to our guests and crew while they sail the world. This is an exciting opportunity to be part of a dynamic team and create lasting memories.Nurse Responsibilities:Perform various technical and non-clinical administrative tasks that support...

Job Summary:You will be working for a fast-growing business process outsourcing provider to provide support to one of our largest accounts and leading provider of healthcare services.This provider serves 959 hospitals and 2979 physician practices with over 50 million patient encounters annually.As an appeals non-clinical collector for one of the leading...

Job Summary:You will be working for a fast-growing business process outsourcing provider to provide support to one of our largest accounts and leading provider of healthcare services.This provider serves 959 hospitals and 2979 physician practices with over 50 million patient encounters annually.As an appeals underpayment collector for one of the leading...

Job Summary:The Healthcare Specialist will review post discharge, prebill accounts that do not have an authorization on file, ALOS versus days authorized variances, and/or other account discrepancies identified that will result in the account being denied by the payor that do not require a clinical review.Communicates with third party payors to resolve...

**Summary**Under supervision and direction of the Clinical Nurse and according to established procedures, provides routine service duties, technical and nursing procedures necessary to provide for care, comfort and safety of patients.Performs tasks, assists patients with personal hygiene and meals and ambulates patients according to specific...

Job SummaryWithin one of the nation's most transformative universities, SJSU's Student Wellness Center (SWC) fosters student opportunity in a revolutionary way by preparing students to maintain lifelong health and well-being. The Student Wellness Center (SWC) provides a variety of medical services, similar to outpatient care provided in a large medical group...

**Work mode**:Hybrid**Onsite Location(s)**:San José, Costa Rica**Additional Locations**: N/A**Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance**- At Boston Scientific, we'll give you the opportunity to harness all that's within you by working in teams of diverse and high-performing employees, tackling some of the...

**Responsibilities**:- Answering incoming calls about collection attempts- Drafting Appeals/Reconsiderations to Workers' Compensation Insurance Carriers regarding Dental (ADA Dental Claim Form), Medical (HCFA1500 Claim Form), & Home Health Care/Durable Medical Equipment (UB-04/DWC10 Claim Form)- Identifying any billing errors- Identifying any payment errors-...

**Field Clinical Specialist IC Costa Rica**: - Remote Eligible: Field Based- Territory: Costa Rica**Additional Locations**: Costa Rica-Coyol; Costa Rica-Heredia **Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - Caring - High Performance** At Boston Scientific, we’ll give you the opportunity to harness all that’s within you by...

**Field Clinical Specialist Sr Structural Heart - San Jose, Costa Rica**:- Remote Eligible: Field Based- Territory: Costa Rica**Additional Locations**: Costa Rica-Coyol; Costa Rica-Heredia**Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - Caring - High Performance**At Boston Scientific, we'll give you the opportunity to harness all...

**Field Clinical Specialist IC - San Jose, Costa Rica**: - Remote Eligible: Field Based- Territory: Costa Rica**Additional Locations**: Costa Rica-Coyol; Costa Rica-Heredia **Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - Caring - High Performance** At Boston Scientific, we’ll give you the opportunity to harness all that’s...

**Field Clinical Specialist IC - San Jose, Costa Rica**:- Remote Eligible: Field Based- Territory: Costa Rica**Additional Locations**: Costa Rica-Coyol; Costa Rica-Heredia**Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - Caring - High Performance**At Boston Scientific, we'll give you the opportunity to harness all that's within you...

Use Your Power for PurposeOur mission is straightforward: empower healthcare decisions regarding the safe and appropriate use of medicines for patients.Whether you are developing the framework to ensure our evidence is scientifically robust, providing unbiased and medically essential expertise, or exploring ways to bridge data gaps, your role is vital.By...

Job OverviewCrg Solutions is a dynamic company seeking a highly skilled Collections Specialist to join our team. As a key member of our finance department, you will play a crucial role in managing our claims and ensuring timely payments.Key ResponsibilitiesRespond to incoming calls regarding collection attemptsDraft appeals and reconsiderations to insurance...

About the RoleCrg Solutions is a leading provider of financial solutions, and we are seeking an experienced Dental Claims Analyst to join our team. In this critical role, you will analyze and resolve dental claims disputes to ensure timely payments.Key AccountabilitiesAnalyze and resolve dental claims disputesDraft and submit appeals and reconsiderations to...

**Work mode**: **Territory**: **Additional Locations**: Costa Rica-Coyol; Costa Rica-Heredia**Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance** - At Boston Scientific, we’ll give you the opportunity to harness all that’s within you by working in teams of diverse and high-performing employees, tackling some of...

Why Patients Need YouPfizer Worldwide Medical and Safety colleagues play a key role in connecting evidenced based, medical decision support with colleagues and stakeholders to enable better health and treatment outcomes.Whether you are creating framework necessary to ensure our evidence is scientifically sound, providing unbiased, medically necessary...

**Summary**Under supervision and direction of the Clinical Nurse and according to established procedures, provides routine service duties, technical and nursing procedures necessary to provide for care, comfort and safety of patients.Performs tasks, assists patients with personal hygiene and meals and ambulates patients according to specific...

**Careers That Change Lives**Bring your sales talents to a leader in medical technology and healthcare solutions.Rooted in our long history of mission-driven innovation, our medical technologies open doors.We support your growth with the training, mentorship, and guidance you need to own your future success.Join us for a career in sales that changes...

Department SummaryThe Valley Foundation School of Nursing is a department within the College of Health and Human Sciences. The School offers Baccalaureate, Master's, and Doctor of Nursing Practice nursing education programs. The programs are accredited by the Commission on Collegiate Nursing Education and approved by the California Board of Registered...

Position Rank and Title:Assistant ProfessorSchool/Department Name:The Valley Foundation School of NursingCompensation:Commensurate with qualifications, experience, and rank as established by the CSU Salary Schedule . Anticipated hiring academic year annual salary range: $100,000 - $150,000,Faculty employee benefits are very competitive for the higher...