Clinical Appeals Specialist Jobs | Glassdoor
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Clinical Appeals Specialist Jobs

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  • 3.3
    Martin Health System – Stuart, FL
    6 days ago 6d
    and regulations pertaining to the clinicalappeal process. The ClinicalAppealsSpecialist and may also be asked to assist the… The ClinicalAppealsSpecialist is responsible for supporting the Martin Health System's appeal process for government audits,…
  • 2.8
    Alameda Health System – Oakland, CA
    Est. Salary $44k-$62k
    25 days ago 25d
    Alameda Health System wants to hear from you! As a ClinicalAppealsSpecialist, you will play a key role in optimizing Highland… responsibility for coordinating and appealingclinical denials per department policy; develops any appeal letters to substantiate the…
  • 2.3
    Innovate Rehab & Wellness – Columbia, MO
    10 days ago 10d
    records to determine appeal status. Research denials and submit appeals. Generate clinically-based appeal letters and position… Summary: Utilize clinical skillset and specialized knowledge base when reviewing, submitting, and appealing documentation requests…
  • 2.4
    21st Century Oncology – Fort Myers, FL
    5 days ago 5d
    documentation, coding & clinical account review Submit appropriate Payer appeals timely Track Appeals to provide information… resource to the ClinicalAppeals Support Coordinator, Central Insurance Verification unit, by monitoring all denials for authorization…
  • 2.8
    Universal Health Services – Richmond, VA
    NEW
    The primary responsibilities of the AppealsSpecialist are the resolution of all appeals relating to technical issues identified… The following are the job requirements for the AppealsSpecialist Position: 1. The qualified candidate for this position…
  • 2.9
    Care New England Health System – Providence, RI
    Est. Salary $61k-$72k
    5 days ago 5d
    ClinicalAppealsSpecialist (RN) Care New England Health System - Finance Job ID: 08244-80805-001 Status Full-Time… REVENUE INTEGRITY DEPARTMENT. Responsible for managing clinical denials and appeals including identifying opportunities to improve payer…
  • 2.7
    Parallon Workforce – San Antonio, TX
    NEW
    Party Payors. SUPERVISOR ClinicalAppeals Director SUPERVISES - ClinicalAppealsSpecialists DUTIES INCLUDE BUT ARE… between the ClinicalAppeals staff and other Patient Account Services staff Resolve issues escalated by ClinicalAppeals staff…
  • 3.2
    INFINITY BEHAVIORAL HEALTH SERVICES – Fort Lauderdale, FL
    EASY APPLY
    5 days ago 5d
    maintain regulatory compliance. INFINITY is now seeking AppealsSpecialists to join our team. INFINITY offers competitive compensation… charts and claims for accuracy. Writing appeals to prove medical necessity with clinical information provided. Prepares and sends…
  • PAS – Nashville, TN
    13 days ago 13d
    Job Summary – The Appeals Collector is responsible for performing follow up on all appeals submitted to the payer for timely… timely payment and resolution. Supervisor –Appeals Manager Supervises – not applicable Duties (included but not limited to): Pursue…
  • 2.8
    Alameda Hospital – Oakland, CA
    Est. Salary $47k-$65k
    11 days ago 11d
    Alameda Health System wants to hear from you! As a ClinicalAppealsSpecialist, you will play a key role in optimizing Highland… responsibility for coordinating and appealingclinical denials per department policy; develops any appeal letters to substantiate the…
  • 2.7
    Parallon – Nashville, TN
    10 days ago 10d
    Job Summary The Appeals Collector is responsible for performing follow up on all appeals submitted to the payer for timely payment… payment and resolution. Supervisor Appeals Manager Supervises not applicable Duties (included but not limited to): Pursue…
  • Shared Services – Richmond, VA
    13 days ago 13d
    to 5:00PM. AppealsSpecialist - ClinicalAppeals – Client Business The AppealsSpecialist is responsible for… tasks for technical appeals: Triage incoming inventory for the Appeals team, validating appeal criteria is met…
  • 1.7
    Fairmount Behavioral Health System – Richmond, VA
    NEW
    The primary responsibilities of the AppealsSpecialist are the resolution of all appeals relating to technical issues identified… The following are the job requirements for the AppealsSpecialist Position: 1. The qualified candidate for this position…
  • 3.4
    Medicare Service Center – Hendersonville, TN
    Est. Salary $67k-$79k
    19 days ago 19d
    in their communities. Job Summary - Handles appeals requiring clinical input or interpretation Key Responsibilities… companies to resolve claims denied for clinical reasons Identify coding or clinical documentation issues and work to correct…
  • 2.7
    Parallon – Richmond, VA
    20 days ago 20d
    to 5:00PM. AppealsSpecialist - ClinicalAppeals – Client Business The AppealsSpecialist is responsible for… tasks for technical appeals: Triage incoming inventory for the Appeals team, validating appeal criteria is met…
  • 3.1
    Kforce – Doral, FL
    14 days ago 14d
    RESPONSIBILITIES: Kforce has a client in that is seeking an AppealsSpecialist/Claims Processor. This position will be covering Doral… Responsibilities: Review provider appeals for physician and hospital appeals Close to 20 a day, if not closed then…
  • 2.9
    CareSource – Dayton, OH
    11 days ago 11d
    Title Provider AppealsSpecialist City Dayton Description Role and Responsibility: § Review appeals submitted by Medicaid… needs claim adjustment, clinical edit denial and claim denial dispute § Prepare all clinical edit appeals for review by computer…
  • 3.8
    Kite Pharma, Inc. – Santa Monica, CA
    NEW
    prior authorizations, pre-determinations, to appeals. The Reimbursement/AppealsSpecialist will be responsible for assisting with gaining… / denial / appeals process; previous direct experience in submitting appeals and advocating for appropriate clinical treatment…
  • 2.2
    HealthSCOPE Benefits – Little Rock, AR
    16 days ago 16d
    AppealsSpecialist Position Code: 345 Department: Appeals Management Location: Little Rock, Arkansas Immediate Supervisor… Coordinate drafting and mailing of letters related to member appeals Prepare feedback and participate in meetings Obtaining…
  • 3.2
    Molina Healthcare – Syracuse, NY
    Est. Salary $55k-$63k
    27 days ago 27d
    Job Summary ClinicalAppeals is responsible for making appropriate and correct clinical decisions for appeals outcomes within… The ClinicalAppeals Nurse (RN) performs clinical/medical reviews of previously denied cases in which a formal appeals request…
  • 2.7
    Parallon – Hendersonville, TN
    Est. Salary $53k-$65k
    19 days ago 19d
    life in their communities. Job Summary - Handles appeals requiring clinical input or interpretation Key Responsibilities Monitor… insurance companies to resolve claims denied for clinical reasons Identify coding or clinical documentation issues and work to correct…
  • 3.1
    The Judge Group – New York, NY
    12 days ago 12d
    is currently seeking a Registered Nurse / Grievance & AppealsSpecialist for our premier client in Manhattan, NY! This job… responsibilities: Performs medical records reviews Prepares clinicalappeals in response to medical necessity denials Analyzes findings…
  • 2.8
    CVS Health – Orlando, FL
    5 days ago 5d
    medications. Job Summary: The Appeals Nurse is primarily responsible for clinical oversight of the appeals process at ACS pharmacy.… · Reviews appeals documents received and develops an appeal letter that includes all of the clinical parameters needed to provide…
  • 2.9
    CareSource (Ohio) – Dayton, OH
    20 days ago 20d
    Assist members when filling appeals; educate member, document and route the information to ClinicalAppeals Coordinator Maintain… Number 17-0756 Post Date 5/9/2017 Title Grievance & AppealsSpecialist City Dayton State OH Description Role and Responsibility…
  • 4.0
    Children's Healthcare of Atlanta – Atlanta, GA
    Est. Salary $54k-$66k
    4 days ago 4d
    Milliman to facilitate appeals for clinical denials. Without prompting, completes timely clinicalappeals for assigned payors and… indexing systems, and third-party reimbursement. Supervises clinicalappeals process and employees that may support the function.…
  • 2.7
    Ahmc Healthcare Inc. – Los Angeles, CA
    NEW
    Location: Garfield Medical Center Job Title: Denials AppealsSpecialist FT Days Department: Case Management Type: Full… 40 Description/Qualifications: The Denials AppealsSpecialist functions as a hospital liaison with external third party…
  • 2.8
    Universal Health Services – Richmond, VA
    25 days ago 25d
    The primary responsibilities of the AppealsSpecialist are the resolution of all appeals relating to technical issues identified… The following are the job requirements for the AppealsSpecialist Position: 1. The qualified candidate for this position…
  • 3.6
    Winthrop-University Hospital – Mineola, NY
    Est. Salary $78k-$96k
    21 days ago 21d
    Coding Specialist (CCS) preferred. Experience: 6 - 8 Years Clinical RN experience required. 1 – 2 Years Clinical documentation… Professional Certifications/Registration: Certified Clinical Documentation Specialist (CCDS), OR Certified Documentation Improvement…
  • 2.8
    CalOptima – Orange, CA
    10 days ago 10d
    The Grievance and Appeals Nurse Specialist will manage the department work activities to ensure that service standards are met… utilization management, quality management, grievances and appeals. Strong interpersonal, verbal and written communication skills…
  • 4.8
    Morgan Stephens – Long Beach, CA
    EASY APPLY
    14 days ago 14d
    who are excited to grow and develop a career. A Claims AppealsSpecialist performs detailed review and analysis to investigate audit… understands health insurance appeals and provider dispute resolution processes, applicable clinical guidelines, and health payer…
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