Clinical Appeals Nurse - National Capital Region

Join our dedicated team at HBiz where we strive to provide outstanding care and service excellence. We are currently seeking a highly skilled Clinical Appeals Nurse to play a crucial role in managing medical denials by providing clinical expertise in the appeals process. · ...

· Details · Join our dedicated team at HBiz where we strive to provide outstanding care and service excellence. We · are currently seeking a highly skilled Clinical Appeals Nurse to play a crucial role in managing medical · denials by providing clinical expertise in the appeal ...

JOB SUMMARY: · The Clinical Appeals Nurse is in responsible for creating a convincing and effective appeal based on clinical documentation, payer-specific standards, and compliance with federal and state policies. The Clinical Appeals Nurse is responsible for clinical denial appe ...

+h2>Job summary · As a Clinical Appeals Nurse at [Company], you will work on post-discharge accounts to resolve discrepancies and escalations. · ...

Access Healthcare is looking for a Registered nurse to join their growing Denials and Appeals team. The role involves ensuring the completion of assigned patient cases by conducting roll calls, processing concurrent and retro clinical reviews, working on surgery authorizations as ...

The work you do with our team will directly improve health outcomes by connecting people with the care and resources they need to feel their best.Come make an impact on the communities we serve as you help us advance health optimization on a global scale. · ...

The US Healthcare Appeals Nurse is responsible for reviewing claims denied and carrying out the appeals process appropriately and in a timely manner. · This individual identifies and works denials, responding to the denial reason and resubmitting any information needed to the pay ...

Access Healthcare is looking for REGISTERED NURSE to join our growing team ensuring completion of assigned patient cases by doing roll calls processing concurrent and retro clinical reviews work processing surgery authorizations as needed. · Perform advanced level work related to ...

· "Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. · Roles and Resp ...

· Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. · Roles and Respo ...

· We're Hiring: Clinical Appeals Writer · Viventis Search Asia is working with a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers. They are currently looking for talented Clinical Appeals Wri ...

Date: Feb 26, 2026 · Location: · Metro Manila, QUE, PH · job- { · display: inline; · } · Company: · NTT DATA Services · Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in a ...

Bachelors degree in Nursing with an active US Registered Nurse License of any state (preferably New York) · Minimum 1-2 years experience in a US Healthcare account (Utilization Management Review and Clinical Appeals) · Exposure to Inpatient/Concurrent reviews · Experience with ut ...

· Job Description: · We are seeking a detail-oriented, knowledgeable, and proactive Clinical Quality Auditor to help ensure the integrity and quality of our clinical appeals. As an internal team member, you'll have the advantage of already being familiar with our processes and c ...

LOOKING FOR FILIPINO CANDIDATES RESIDING IN THE PHILIPPINES. · We are hiring for Clinical Appeals Writer · Qualifications: · Basic Clinical Appeals writing experience · At least 1+ years of Clinical / Hospital Experience. · BS Nursing graduate. · With an active PHRN / USRN Licens ...

· We're in need of an SNF (Skilled Nursing Facility) Biller who will be responsible for managing the billing and collection processes in a healthcare environment, particularly for skilled nursing facilities with proficiency in using PCC(PointClickCare). The role is crucial for e ...

+ · We are hiring two (2) Remote Nurses to support clinical and administrative workflows focused on patient documentation, chart preparation, and sleep-related care coordination.+Clinical Documentation & Chart Preparation · Patient Case Management · ...

· We are looking for a Remote Nurse · We Offer: · A full remote work opportunity · Hourly rate: $6/hr · Fulltime · Weekly salary payout · We are seeking two dedicated Remote Nurses to join our team. The ideal candidate will have experience in clinical and nonclinical tasks relat ...

· We are looking for Remote Nurses · We Offer: · A full remote work opportunity · Hourly rate: $5/hr · Fulltime · Weekly salary payout · We are seeking two dedicated Remote Nurses to join our team. The ideal candidate will have experience in clinical and nonclinical tasks relate ...

Key Responsibilities: · Review and analyze claims that have been denied due to coding-related issues, including diagnosis codes (ICD-10-CM), procedure codes (CPT/HCPCS), and related modifiers. · Identify coding discrepancies, documentation deficiencies, and other factors contribu ...