Get new jobs for this search by email
RN Appeals Writer-PRN
Piedmont Healthcare - Atlanta, Georgia, us, 30301 1 days ago
RESPONSIBLE FOR:Detailed review, analysis and extraction of clinical information from patient medical records and drafting ofeffective narratives for ...
More...
PT Operator Technician
Hearst Television - Pittsburgh, PA USA 1 years ago
WTAE-TV, the Hearst-owned ABC affiliate in Pittsburgh, PA is interviewing candidates for a part-time broadcast Operator Technician.Job Responsibilitie...
More...
Senior Director, Events Marketing
C3 IoT - Redwood City, CA 3 days ago
C3.ai, Inc. (NYSE:AI) is a leading Enterprise AI software provider for accelerating digital transformation. The proven C3 AI Platform provides compreh...
More...
Graphic Designer and Marketing Support
Old Republic - Phoenix, Arizona, United States, 85003 23 hours ago
Job Description:OLD REPUBLIC TITLE HOLDING COMPANY, INCJob Summary:We are seeking a talented and experienced Graphic Designer to join our dynamic team...
More...
Creative - Production Designer
Tailored Management - San Francisco, California, United States, 94199 23 hours ago
Are you a creative powerhouse with a passion for storytelling through stunning visual designs? Do you thrive in fast-paced environments, where every d...
More...
Specialist, Digital Marketing
Mindlance - Dublin, Ohio, United States, 43016 1 days ago
Title: Specialist, Digital MarketingLocation: RemoteDuration: 6 MonthsWorks with internal clients such as Product Marketing teams and develops digital...
More...
Entry Level Marketing Assistant
QCC, LLC - Indianapolis, Indiana, us, 46262 1 days ago
We are actively seeking a motivatedEntry Level Marketing Assistantto join our dynamic team. This position is an essential part of our marketing and ad...
More...
Entry Level Marketing Assistant
QCC, LLC - Dublin, Ohio, United States, 43016 2 days ago
We are actively seeking a motivatedEntry Level Marketing Assistantto join our dynamic team. This position is an essential part of our marketing and ad...
More...
Entry Level Marketing Assistant
QCC, LLC - Alameda, California, United States, 94501 2 days ago
We are actively seeking a motivatedEntry Level Marketing Assistantto join our dynamic team. This position is an essential part of our marketing and ad...
More...
Go to next pagePiedmont Healthcare - Atlanta, Georgia, us, 30301
Work at Piedmont Healthcare
RESPONSIBLE FOR:
Detailed review, analysis and extraction of clinical information from patient medical records and drafting of
effective narratives for Medicare and Medicaid appeals documentation and briefs in support of denied cases
under appeal at all levels of the government appeals process; maintaining current knowledge base of
medical coding, federal and state hospital Utilization Review (UR) regulations and Medicare guidelines
regarding medical necessity, inpatient, outpatient and observation; assisting Senior Director with research
and preparation for beneficiary hearings before the Administrative Law Judge (ALJ); potentially testifying
as expert witness in ALJ hearings; collaborating with internal and external legal resources in an effort to
facilitate the best possible outcomes in response to process or guideline changes that directly impact the
RAC process.
MINIMUM EDUCATION REQUIRED:
Graduate from an accredited School of Nursing
MINIMUM EXPERIENCE REQUIRED:
Clinical experience in healthcare setting with a minimum of 7 years using electronic medical records or
acute hospital utilization review using InterQual or Milliman. Working knowledge of medical coding, case
management, government and contracted payers.
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
Current Georgia nursing licensure.
ADDITIONAL QUALIFICATIONS:
Experience in clinical software such as SCM / Quest, STAR, EPIC, Client Tracking, and I-Suites. Previous
experience with medical record auditing with medical necessity claims; IQCI Certification preferred
MicroSoft Word and Excel proficiency preferred. HealthPort systems experience a plus.
LI-POST
#GD
See details and apply
RN Appeals Writer-PRN