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Showing 1-10 of 234
Clinical appeals reviewer jobs

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MedRisk LLC - King of Prussia, PA

The InitialClinical Reviewer conducts a clinical review of all assigned cases to provideefficient, cost-effective, quality clinical review services....

Bournewood Health Systems - Brookline, MA

You will conduct clinical reviews and initiate appeals. We are seeking a full-time utilization reviewer to be responsible to monitor and assess level of care,...

UPMC - Pittsburgh, PA

Act as first level physician reviewer for all cases referred by the Quality Improvement and Care Management Departments....

Adventist Health Southern California - Glendale, CA

The Appeals Reviewer RN is responsible for recovering revenue associated with disputed/denied clinical claims or those eligible for clinical review, and the...

AmeriHealth Caritas - Philadelphia, PA

Minimum of 3 years of clinical experience, with both adult and pediatric populations, within an acute care setting required....

Washington Hospital Center - Washington, AR

PRIOR EXPERIENCE Three to five years experience as a clinical nurse in an acute care setting. Serves as communication liaison between registered nurse case...

Adventist Health - Glendale Adventist Medical Center - Glendale, CA

The Appeals Reviewer RN is responsible for recovering revenue associated with disputed/denied clinical claims or those eligible for clinical review, and the...

Chinese Hospital - San Francisco, CA

Utilization Management Nurse Reviewer. Authorizes requests for services using Milliman clinical guidelines;...

Horizon Blue Cross Blue Shield of New Jersey - Trenton, NJ

Assists or consults on appeal review process. Requires broad clinical knowledge and understanding of current health care issues....

HealthCare Support Staffing - Denver, CO

Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management...


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