Expired Appeals Nurse jobs in Allentown, PA
Allentown, PA
$26,235-$128,068/year (est.)
Req ID: 68628BR Job Description This full time position is part of a team of a number of Complaint and Appeal Nurse Analysts and Complaint and Appeal Analysts. Our team provides comprehensive post-service utilization management review for providers. Part of our team also reviews cases that are DRG...
Allentown, PA
$26,191-$127,856/year (est.)
Job Summary: Reviews payor denials and audits for potential lost revenue. Writes comprehensive, factual arguments to present to third-party payers, medical review boards, or other responsible parties applying clinical criteria to establish medical necessity. Functions as a hospital liaison with...
Allentown, PA
$26,235-$128,068/year (est.)
Req ID: 64981BR Job Description Responsible for the review and resolution of clinical complaints and appeals. Interprets data obtained from clinical records to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and provider issues....
Allentown, PA
$26,235-$128,068/year (est.)
Description: Responsible for the review and resolution of clinical documentation, clinical complaints and appeals. Reviews documentation and interprets data obtained from clinical records to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for...