UnitedHealth Group - Norristown, PA

Our Clinical Appeals Reviewer coordinates Medical Director Reviews, Appeal Reviews and Peer Reviews within the Review Services department, acting independently...

DeKalb Medical - Decatur, GA

Appeal payment for services denied by Medicare, Medicaid, and Commercial payers by writing and presenting letters of appeal to Insurance Reviewers, Hearing...

Estimated: $58,000 - $78,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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Washington & West, LLC - Towson, MD

To review medical charts and write appeals to insurance companies. Apply clinical judgment and knowledge for level of care and medical necessity reviews....

Estimated: $44,000 - $56,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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Healthplex, Inc. - Uniondale, NY

If requested, to participate as a member of the Complaint and Appeals Review Committee. The primary function of the Clinical Reviewer is to review dental claim...

Estimated: $46,000 - $67,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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UnitedHealth Group - San Francisco, CA

The denials may include Pre-Service and Concurrent UM and administrative requests, Post-Service cases (retrospective reviews, Clinical Claims Review) and...

UnitedHealth Group - Philadelphia, PA

The denials may include Pre-Service and Concurrent UM and administrative requests, Post-Service cases (retrospective reviews, Clinical Claims Review) and...

UnitedHealth Group - St. Louis, MO

The denials may include Pre-Service and Concurrent UM and administrative requests, Post-Service cases (retrospective reviews, Clinical Claims Review) and...

Noridian Healthcare Solutions, LLC - Rapid City, SD

Reviews complex appeals. 2 years’ clinical experience. The Clinical Reviewer is responsible for reviewing documentation, making clinical determinations for...

Estimated: $51,000 - $65,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Noridian Healthcare Solutions, LLC - Minot, ND

Reviews complex appeals. 2 years’ clinical experience. The Clinical Reviewer is responsible for reviewing documentation, making clinical determinations for...

Estimated: $53,000 - $69,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Noridian Healthcare Solutions, LLC - Grand Forks, ND

Reviews complex appeals. 2 years’ clinical experience. The Clinical Reviewer is responsible for reviewing documentation, making clinical determinations for...

Estimated: $49,000 - $69,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Noridian Healthcare Solutions, LLC - Bismarck, ND

Reviews complex appeals. 2 years’ clinical experience. The Clinical Reviewer is responsible for reviewing documentation, making clinical determinations for...

Estimated: $53,000 - $70,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Noridian Healthcare Solutions, LLC - Kansas City, MO

Reviews complex appeals. 2 years’ clinical experience. The Clinical Reviewer is responsible for reviewing documentation, making clinical determinations for...

Estimated: $48,000 - $65,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Noridian Healthcare Solutions, LLC - Des Moines, IA

Reviews complex appeals. 2 years’ clinical experience. The Clinical Reviewer is responsible for reviewing documentation, making clinical determinations for...

Estimated: $50,000 - $69,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Noridian Healthcare Solutions, LLC - Sioux Falls, SD

Reviews complex appeals. 2 years’ clinical experience. The Clinical Reviewer is responsible for reviewing documentation, making clinical determinations for...

Estimated: $50,000 - $67,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Noridian Healthcare Solutions, LLC - Omaha, NE

Reviews complex appeals. 2 years’ clinical experience. The Clinical Reviewer is responsible for reviewing documentation, making clinical determinations for...

Estimated: $48,000 - $68,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

WellCare - Tampa, FL

Utilizes WellCare designated criteria along with clinical knowledge to make authorization decisions and assist the Medical Director with appeal determinations....

Estimated: $37,000 - $51,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Centene Corporation - Chesterfield, MO

Assist SIU Clinical Supervisor/Manager as needed with training new hires, answering questions from Clinical Reviewer I employees, auditing work of junior-level...

Estimated: $50,000 - $68,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Centene Corporation - New Orleans, LA

Assist SIU Clinical Supervisor/Manager as needed with training new hires, answering questions from Clinical Reviewer I employees, auditing work of junior-level...

Estimated: $51,000 - $72,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

National Medical Reviews - Remote

Under the direction of the Chief Medical Director, provides peer reviews services, which may include but not limited to, benefit coverage opinions, case reviews...

Estimated: $100,000 - $130,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

State of Ohio Jobs - Ohio

Read & comprehend clinical records; Testifies before state hearings &/or administrative appeals; Read & comprehend clinical records & residence &/or clinical...

$27 an hour

Hawaii Medical Service Association - Kapolei, HI

Three years clinical, case management or utilization management related experience. Call providers when additional clinical information is required to clarify...

Estimated: $59,000 - $76,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

HQI - Work at Home

Clinical or direct patient care:. Describing and communicating health care appeals issues. Five (5) years of clinical or direct patient care *....

Estimated: $130,000 - $190,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

HMS - Texas

Experience with clinical hearing procedures, legal proceedings, preferred. Coordinates case assignment with the state client, Medical Director and physician...

Estimated: $76,000 - $96,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

Professional Management Enterprises - Indianapolis, IN

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

Estimated: $51,000 - $71,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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Aerotek - Watertown, MA

Assists Medical Director with CCS appeals as applicable. Applies managed care techniques to clinical practice within established criteria....

Estimated: $83,000 - $110,000 a year

Please note that all salary figures are approximations based upon third party submissions to SimplyHired or its affiliates. These figures are given to the SimplyHired users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures.

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MetaStar, Inc. - Madison, WI

Clinical practice working with target populations:. Review and mediation activities associated with FC, FCP, PACE, IRIS waiver programs member appeals and...

$55,000 - $65,000 a yearSponsored