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Full Time 7p - 7a Virtual Nurse works from an on-site office location (not a remote position) Will perform admit, discharge chart review and other patient care duties from an office location via secure virtual link to patient rooms.
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Avosys is seeking a Bexar County Remote Registered Nurse - Medical Review Specialist to work remotely to review Medicare claims. Active and current Registered Nurse license.
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The Review Nurse Clinical Reviewer position encompasses multiple responsibilities including Core Measure chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews & is proactive in working with departments on timely corrective actions.
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Performs retrospective (post –discharge/ post-service) medical necessity reviews to determine appellate potential of clinical disputes/denials or those eligible for clinical review. Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step JOB SUMMARY The Revenue Cycle Clinician for the Appellate Solution is responsible for: a) Recovering revenue associated with disputed/denied clinical claims or those eligible for clinical review b) Preparing and documenting appeal based on industry accepted criteria.
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Looking for experienced Emergency Department or Pre-Hospital Registered Nurses to staff the EMS room at Beaver Stadium for football games and other mass gatherings as needed. The ASR is available for review here.
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We are seeking a talented individual for a Nurse Reviewer who will be responsible for performing clinical reviews to determine if the medical record documentation supports the need for the service based on clinical criteria, coverage policies, and utilization and practice guidelines as defined by review methodologies specific to the contract for which services are being provided.
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Active registered nurse (RN) license in [state/country of employment]. Optavise, a CNO Financial Group Company is seeking a Registered Nurse Advocate to take on a pivotal position where you provide essential support and education to our team of advocates and members.
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Evaluate prior authorization requests for medical necessity and review medical records for insurance appeals. Stay informed about current nursing practices through continuous education and literature review.
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Abide by Stormont Vail’s Remote Worker Policy and will review and acknowledge the Remote Work Agreement annually. Licenses and CertificationsLicensed Practical Nurse - KSBN RequiredBasic Life Support - BLS Required within 90 days of hire.
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Shift: 5x8HR DAYS (8:00-16:30) – this will be fully remote and not patient facing. The CDS's primary responsibility will be to obtain appropriate clinical documentation through extensive review of provider, nursing, ancillary, and other patient caregivers' documentation, to ensure that appropriate documentation and reimbursement is received for the level of services rendered to patients.
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Training Location: Beverly Hills 80% remote and 20% in office Must be available for onsite observations as needed/applicable Position if focused on Patient Safety. Perform outpatient case review of hospitalizations related to re-admissions and sentinel diagnoses, and identify opportunities for care improvement.
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Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) as a Registered Nurse (RN). Above satisfactory job performance in the managed care environment with a focus on Utilization Management (UM), Prior Authorization (PA), Claims, Medical Review, Case Management, and/or Medical Appeals and Grievance (MAG.
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Registered Nurse (RN) Case Manager ($45 per hour) Fully remote position. Review medications and counsel members on complex pharmacy needs. Fully remote position. Registered Nurse (RN) Case Manager ($45 per hour.
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Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Sr. Appeals & Grievances Registered Nurse. Hybrid role, may allow fully remote work. The successful RN candidate will review both inpatient and outpatient Medicare member appeals for benefits, medical necessity, coding accuracy and medical policy compliance.
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We are seeking multiple Registered Nurses (RNs) in the Greater Boston Area who are interested in permanent Case Management roles to start ASAP. These are NOT remote positions. Review of care plans, and participating in assessments.
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review remote registered nurse jobs Title: registered nurse
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