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Part Time Interqual Jobs (NOW HIRING)

Xsolis

Physician Advisor (Part Time)

Franklin, TN · On-site +1

Be able to review cases with screening criteria, such as InterQual, MCG or other appropriate platforms. Develop and apply protocols related to evidence-based medicine and criteria. * Work with ...

Endeavor Health

RN Care Manager-Per Diem

Glenview, IL · On-site

$40.45 - $62.70/hr

Glenview, IL * Full Time/Part Time: Per Diem - rotating shifts * Hours: Monday-Friday, 11:00a-11 ... Knowledge of InterQual or MCG criteria is preferred. What you will do: * Facilitates payor ...

NorthShore

RN Care Manager-Nights

Glenview, IL · On-site

$40.45 - $62.70/hr

Glenbrook, IL * Part Time: 20 hours per week, night shift * Hours: Saturday and Sunday, 9:30p-7:00a ... Knowledge of InterQual or MCG criteria is preferred. * Clinical certification, such as case ...

Endeavor Health

RN Care Manager-Nights

Glenview, IL

$40.45 - $62.70/hr

Glenbrook, IL * Part Time: 20 hours per week, night shift * Hours: Saturday and Sunday, 9:30p-7:00a ... Knowledge of InterQual or MCG criteria is preferred. * Clinical certification, such as case ...

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How much do part time interqual jobs pay per hour?

As of May 31, 2026, the average hourly pay for part time interqual in the United States is $26.60, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $29.57 per hour, depending on experience, location, and employer.

What is the difference between Part Time Interqual vs Part Time Utilization Review Nurse?

AspectPart Time InterqualPart Time Utilization Review Nurse
CertificationsTypically requires Interqual certification or trainingRequires nursing license and possibly utilization review certification
Work EnvironmentHealthcare facilities, insurance companies, or consulting firmsHospitals, insurance companies, or healthcare organizations
Job FocusApplying Interqual criteria to assess medical necessityReviewing patient records to determine appropriate care and coverage
Common UsageUsed by healthcare organizations for criteria-based assessmentsUsed by insurance companies and hospitals for utilization management

Part Time Interqual professionals focus on applying specific criteria tools like Interqual to evaluate medical necessity, often requiring specialized certification. In contrast, Part Time Utilization Review Nurses use their nursing expertise to review patient records for appropriate care, typically holding a nursing license. Both roles are integral to healthcare quality and insurance processes but differ mainly in certification requirements and job focus.

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Part Time Interqual jobs near you
Clinical Appeals Coordinator | Concord Hospital | Part Time

Clinical Appeals Coordinator | Concord Hospital | Part Time

Concord Hospital

Concord, NH • On-site

$22.25 - $27.50/hr

Part-time

Posted 21 days ago

Concord Hospital Health System rating

7.0

Company rating: 7.0 out of 10

Based on 67 frontline employees who took The Breakroom Quiz

401st of 864 rated healthcare providers

Job description

Summary
The Clinical Appeals Coordinator is responsible for supporting Concord Hospital with claim appeal activities within the Revenue Integrity department. This involves a timely and accurate review of medical records in response to claim denials received from third party payers, Recovery Audit Contractors (RAC), Medicare Administrative Contractors (MAC), as well as medical necessity denials from other governmental and non-governmental payers and auditors. The Clinical Appeals Coordinator will evaluate opportunities for education and provide feedback to physicians the RCC Committee, and other relevant departments. Additionally, this person will serve as a clinical resource to the entire Revenue Management division.
Education
Bachelor's degree in Nursing from an accredited Nursing program.
Certification, Registration & Licensure
Experience
Minimum of five years' experience in utilization review and/or auditing in an acute-care hospital setting. Medicare audit and appeal background strongly desired. Must have solid understanding of Medicare levels of care (inpatient/observation). Experience applying Milliman and/or Interqual guidelines required. Familiarity with medical coding, reimbursement, and insurance practices required. Must possess excellent interpersonal, communication, and motivational skills, including the ability to communicate clearly and concisely, both orally and in writing. Ability to work collaboratively with individuals at all levels throughout the organization required. Strong facilitation and presentation skills required. Must use independent judgment in reviewing records to determine appropriate appeal action. Must be able to compose a persuasive appeal using clinical data, regulatory guidelines, evidence-based standards, and applicable legal statute. Strong organizational and time management skills required. Must be able to independently prioritize work. Strong critical-thinking and problem solving skills required. Must be flexible and comfortable in an environment with frequent changing demands and requirements. Strong computer skills required including MS Word and Excel.
Responsibilities
  • Performs audits on all assigned clinical denials.
  • Constructs all necessary appeals with payers for reconsideration of denied charges and/or services.
  • Identifies root cause of denials and provides education to Care Managers, Providers and Charge Departments as appropriate.
  • Acts as a clinical resource to Patient Financial Services and other Concord Hospital departments for payment/charge issues and other clinical inquiries that may or may not be related to audits and appeals.
  • Takes responsibility for individual performance goals.
  • Performs other duties as assigned.

Concord Hospital is an Equal Employment Opportunity employer. It is our policy to provide equal opportunity to all employees and applicants and to prohibit any discrimination because of race, color, religion, sex, sexual orientation, gender, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.
Know Your Rights: Workplace Discrimination is Illegal
Applicants to and employees of this company are protected under federal law from discrimination on several bases. Follow the link above to find out more.
If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, you may contact Human Resources at 603-230-7269.

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