Clinical Payer Integrity Nurse

Job not on LinkedIn

🕒 July 20

Apply Now
Find Similar Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Logo of UK King's Daughters Workforce Institute

UK King's Daughters Workforce Institute

- employees

🏥 Healthcare

📚 Education

Healthcare • Education

UK King's Daughters Workforce Institute is an organization focused on shaping the future of healthcare by preparing and empowering the next generation of healthcare professionals. The Institute appears to concentrate on workforce development, education, training, and professional development initiatives aimed at addressing healthcare staffing needs and improving the skills and readiness of clinical and allied health workers. It operates within the hospitals and health care sector and emphasizes equipping learners and professionals to make meaningful impact in clinical settings.

📋 Description

• Responsible for ensuring accurate reimbursement by resolving denied claims through effective appeals processes • Reviews and analyzes denials to identify root causes and opportunities for successful resolution • Collaborates with clinical and billing teams to gather documentation and support appeals • Develops strategies to retain appropriate reimbursement and monitors outcomes to improve future processes

🎯 Requirements

• Bachelor’s degree in nursing, healthcare administration, or a related field • 2-3 years of experience in clinical review, payer integrity, utilization management, or a relevant area • Must maintain active RN licensure • An equivalent combination of education and experience may be considered

🏖️ Benefits

• Flexible work arrangements • Professional development opportunities

Apply Now

Similar Jobs

🕒 July 16

UBC

1001 - 5000

🏥 Healthcare

💼 Consulting

🧬 Biotechnology

Telephonic Nurse Ambassador providing clinical support and patient care services for healthcare providers. Responsible for telephonic communications, patient access facilitation, and case management.

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🕒 July 16

UBC

1001 - 5000

🏥 Healthcare

💼 Consulting

🧬 Biotechnology

Clinical Case Manager providing telephonic support in healthcare. Supporting healthcare providers and patients with telephonic assistance and reimbursement processes.

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🕒 July 14

Vaya Health

501 - 1000

🛡️ Insurance

💼 Consulting

📦 Logistics

Physical Health Registered Nurse responsible for clinical reviews and service authorization requests with Vaya Health. Collaborates with medical professionals to ensure quality care for members.

🇺🇸 United States – Remote

💵 $68k - $88.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🕒 July 10

Devoted Health

1001 - 5000

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Utilization Management Nurse reviewing inpatient, behavioral health, and post-acute services. Responsible for ensuring adherence to CMS and Medicare Advantage regulations.

🇺🇸 United States – Remote

💵 $85k - $95k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🕒 July 6

Valeris

1001 - 5000

💊 Pharmaceuticals

🏥 Healthcare

🤝 B2B

Patient Support Nurse at Valeris facilitating care coordination and education for patients in a telephonic setting. Supporting nephrology patients and healthcare providers with medication and disease state education.

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior