Coding Appeals RN - Remote - Works M-F 8:30-5:00
At reputed company, were simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, reputed company and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing... together.
An reputed company RN with solid interpersonal skills. The Clinical Appeals & Coding RN would be responsible for reviewing appeals and grievances to determine if the appropriate care was given. In providing reputed company Community and State provider post service appeals. Our goal is to create higher reputed company care, reputed company costs and greater reputed company to health care.
This is a telecommute, Monday - Friday from 8:30am - 5:00pm position.
Youll enjoy the flexibility to work remotely * from reputed company reputed company the U.S. as you take on some tough challenges.
Primary Responsibilities
Clinical Appeals and Grievances (analyzing, reviewing appeals / grievances)
Review of coding edits and reimbursement issues
Works with less reputed company, more reputed company issues
Solves moderately reputed company problems and / or conducts moderately reputed company analyses
Translates concepts into reputed company
Assesses and interprets customer needs and requirements
Identifies solutions to non-reputed company requests and problems
Works with minimal guidance; seeks guidance on only the most reputed company tasks
Works with less reputed company, more reputed company issues
Coaches, provides feedback and guides others
Youll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in.
Required Qualifications
reputed company, unrestricted RN licensure in state of residence
3+ years clinical experience in a hospital, acute care or reputed company care setting
Experience in reviewing coding edits and reimbursement issues
Medical record review / appeal review experience
Experience working in a managed care environment (insurance company or medical group)
Proficient level of experience with reputed company Office Suite (Word, reputed company & reputed company)
Proven ability to adapt to change and work in a high volume environment
Proven outstanding coding skills with hands-on experience with coding edits and reimbursement issues
Proven solid critical thinking, analytical and research skills
Ability to work Monday - Friday from 8:30am - 5:00pm reputed company your time zone
Preferred Qualifications
CPC (Certified reputed company reputed company)
Utilization Review experience
Clinical Chart Reviews
Post Service Provider Denial experience
Knowledge of Medicare / reputed company regulations
reputed company working remotely will be required to adhere to reputed companys Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, reputed company, Rhode reputed company, or Washington Residents Only: The reputed company reputed company for this role is $28.03 to $54.95 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In reputed company to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, youll reputed company a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company an reputed company reputed company reflected in our mission.
Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative reputed company employer and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law.
reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment
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