Writes comprehensive, factual arguments to present to third-party payers, medical review boards, or ... Clinical Appeals Nurse - Full Time Remote - Jefferson Health Articulates the job's main ...
Writes comprehensive, factual arguments to present to third-party payers, medical review boards, or ... Clinical Appeals Nurse - Full Time Remote - Jefferson Health Articulates the job's main ...
Registered Dietitian (Part-Time) - Pennsylvania Licensed (Remote - US)
Philadelphia, PA · On-site +1
$50/hr
About Season Season Health is rethinking nutrition-based healthcare. As a remote-organization, we ... Write nutrition prescriptions tailored to clinical diagnoses and promote sustainable behavior ...
Registered Dietitian (Part-Time) - Pennsylvania Licensed (Remote - US)
Philadelphia, PA · On-site +1
$50/hr
About Season Season Health is rethinking nutrition-based healthcare. As a remote-organization, we ... Write nutrition prescriptions tailored to clinical diagnoses and promote sustainable behavior ...
$19.25 - $25.25/hr
This is a remote position. As a key member of our care team, you will engage with members in person ... Bilingual proficiency (spoken and written). * Formal training or demonstrated skill in motivational ...
$19.25 - $25.25/hr
This is a remote position. As a key member of our care team, you will engage with members in person ... Bilingual proficiency (spoken and written). * Formal training or demonstrated skill in motivational ...
Entry Level / Data Entry Assistant (Remote)
Philadelphia, PA · Remote
$17 - $22.50/hr
Excellent written and verbal communication skills. Ability to work independently and manage time ... Maintain a healthy work-life balance with flexible work schedules. Professional development: Access ...
Entry Level / Data Entry Assistant (Remote)
Philadelphia, PA · Remote
$17 - $22.50/hr
Excellent written and verbal communication skills. Ability to work independently and manage time ... Maintain a healthy work-life balance with flexible work schedules. Professional development: Access ...
... healthcare technology programs. You will recruit for a wide range of Information Technology ... Excellent verbal and written communication skills with the ability to build strong relationships ...
... healthcare technology programs. You will recruit for a wide range of Information Technology ... Excellent verbal and written communication skills with the ability to build strong relationships ...
... healthcare technology programs. You will recruit for a wide range of Information Technology ... Excellent verbal and written communication skills with the ability to build strong relationships ...
... healthcare technology programs. You will recruit for a wide range of Information Technology ... Excellent verbal and written communication skills with the ability to build strong relationships ...
... healthcare technology programs. You will recruit for a wide range of Information Technology ... Excellent verbal and written communication skills with the ability to build strong relationships ...
... healthcare technology programs. You will recruit for a wide range of Information Technology ... Excellent verbal and written communication skills with the ability to build strong relationships ...
Remote Transportation Care Coordinator
Montoursville, PA · Remote
$11.50 - $12/hr
If you have healthcare scheduling, customer service, and/or call center experience, we want to hear ... Excellent written and verbal communication skills; both internally and externally, ensuring clarity ...
Remote Transportation Care Coordinator
Montoursville, PA · Remote
$11.50 - $12/hr
If you have healthcare scheduling, customer service, and/or call center experience, we want to hear ... Excellent written and verbal communication skills; both internally and externally, ensuring clarity ...
Remote Transportation Care Coordinator
Montoursville, PA · On-site +1
$11.50 - $12/hr
If you have healthcare scheduling, customer service, and/or call center experience, we want to hear ... Excellent written and verbal communication skills; both internally and externally, ensuring clarity ...
Remote Transportation Care Coordinator
Montoursville, PA · On-site +1
$11.50 - $12/hr
If you have healthcare scheduling, customer service, and/or call center experience, we want to hear ... Excellent written and verbal communication skills; both internally and externally, ensuring clarity ...
The Healthcare Analytics Solutions team is seeking a dynamic, analytical, and highly motivated ... Execute post-conference lead nurturing by conducting initial written outreach via email and ...
The Healthcare Analytics Solutions team is seeking a dynamic, analytical, and highly motivated ... Execute post-conference lead nurturing by conducting initial written outreach via email and ...
Psychotherapist - Behavioral Health -P/T Evenings Remote -PA Licensure Required
Bethlehem, PA · On-site +1
... health care. Remote 4-8 or 5-9 pm (20hrs.) The Psychotherapist provides counseling within an ... Able to communicate effectively (both verbally and in writing). Positive interpersonal skills ...
Psychotherapist - Behavioral Health -P/T Evenings Remote -PA Licensure Required
Bethlehem, PA · On-site +1
... health care. Remote 4-8 or 5-9 pm (20hrs.) The Psychotherapist provides counseling within an ... Able to communicate effectively (both verbally and in writing). Positive interpersonal skills ...
Approval of remote and hybrid work is not guaranteed regardless of work location.For additional ... Perform statistical analyses using SAS or other statistical software packages, including writing ...
Approval of remote and hybrid work is not guaranteed regardless of work location.For additional ... Perform statistical analyses using SAS or other statistical software packages, including writing ...
Healthcare Litigation Attorneys
Pittsburgh, PA · On-site +1
Candidates must be driven team players with excellent litigation, writing, and persuasive speaking ... We offer flexible work models for successful candidates, including fully remote and hybrid ...
Healthcare Litigation Attorneys
Pittsburgh, PA · On-site +1
Candidates must be driven team players with excellent litigation, writing, and persuasive speaking ... We offer flexible work models for successful candidates, including fully remote and hybrid ...
Healthcare Litigation Attorneys
Pittsburgh, PA · On-site +1
Candidates must be driven team players with excellent litigation, writing, and persuasive speaking ... We offer flexible work models for successful candidates, including fully remote and hybrid ...
Healthcare Litigation Attorneys
Pittsburgh, PA · On-site +1
Candidates must be driven team players with excellent litigation, writing, and persuasive speaking ... We offer flexible work models for successful candidates, including fully remote and hybrid ...
This position works Monday through Friday, daylight hours and will be a remote position. The Member ... writing according to department standards. * Effectively utilize key internal and external Health ...
This position works Monday through Friday, daylight hours and will be a remote position. The Member ... writing according to department standards. * Effectively utilize key internal and external Health ...
Clinical Appeals Analyst (Remote) - FT The Clinical Appeals Analyst is responsible for assisting ... The Clinical Appeals Analyst will write sound, compelling letters to support the appeal. • Review ...
Clinical Appeals Analyst (Remote) - FT The Clinical Appeals Analyst is responsible for assisting ... The Clinical Appeals Analyst will write sound, compelling letters to support the appeal. • Review ...
... healthcare professionals. With a mission-driven culture and a track record of internal career ... Strong written and verbal communication skills * Self-starter with a high degree of initiative ...
... healthcare professionals. With a mission-driven culture and a track record of internal career ... Strong written and verbal communication skills * Self-starter with a high degree of initiative ...
$42 - $47/hr
This is a remote position. We are seeking a passionate and experienced HSS Clinical Coordinator RN ... care/health plan environments (preferred) * Excellent verbal and written communication skills ...
$42 - $47/hr
This is a remote position. We are seeking a passionate and experienced HSS Clinical Coordinator RN ... care/health plan environments (preferred) * Excellent verbal and written communication skills ...
Inside Sales Agent - Remote
Mcmurray, PA · Remote
$95K - $110K/yr
Communicate effectively (written and verbal) * Deliver excellent customer service and maintain ... Health coverage for medical, dental, vision 401(K) saving plans with company match Tuition ...
Inside Sales Agent - Remote
Mcmurray, PA · Remote
$95K - $110K/yr
Communicate effectively (written and verbal) * Deliver excellent customer service and maintain ... Health coverage for medical, dental, vision 401(K) saving plans with company match Tuition ...
Inside Sales Agent - Remote
Washington, PA · Remote
$95K - $110K/yr
Communicate effectively (written and verbal) * Deliver excellent customer service and maintain ... Health coverage for medical, dental, vision 401(K) saving plans with company match Tuition ...
Inside Sales Agent - Remote
Washington, PA · Remote
$95K - $110K/yr
Communicate effectively (written and verbal) * Deliver excellent customer service and maintain ... Health coverage for medical, dental, vision 401(K) saving plans with company match Tuition ...
Remote Health Blog Writer information
What is the difference between Remote Health Blog Writer vs Remote Health Content Editor?
| Aspect | Remote Health Blog Writer | Remote Health Content Editor |
|---|---|---|
| Credentials | Writing experience, healthcare knowledge, possibly certifications in health writing | Same as writer, plus editing and proofreading skills |
| Work Environment | Remote, freelance or contract basis, independent work | Remote, often part of a team, overseeing content quality |
| Industry Usage | Creating original health blog content for websites and publications | Reviewing, editing, and refining health content before publication |
| Search & Comparison Intent | Looking for writing opportunities or roles | Seeking editing or content management roles |
The main difference between a Remote Health Blog Writer and a Remote Health Content Editor lies in their responsibilities. Writers focus on creating original health content, while editors review and improve existing content. Both roles require healthcare knowledge and writing skills, but editors need additional editing expertise. Understanding these distinctions helps job seekers find roles aligned with their skills and career goals.
What are popular job titles related to Remote Health Blog Writer jobs in Pennsylvania? For Remote Health Blog Writer jobs in Pennsylvania, the most frequently searched job titles are:
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What job categories do people searching Remote Health Blog Writer jobs in Pennsylvania look for? The top searched job categories for Remote Health Blog Writer jobs in Pennsylvania are:
What cities in Pennsylvania are hiring for Remote Health Blog Writer jobs? Cities in Pennsylvania with the most Remote Health Blog Writer job openings:
Clinical Appeals Nurse - Full Time Remote - Jefferson Health
Philadelphia, PA • On-site, Remote
Full-time
Medical, Dental, Vision, Life, Retirement
Posted 27 days ago
Jefferson Health rating
7.7
Based on 348 frontline employees who took The Breakroom Quiz
160th of 887 rated healthcare providers
Job description
Job Details
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 external third-party payors to appeal denied claims. Works closely with Physician advisor team to facilitate appeals to payors. Monitors and reports payor trends to management team.
Job Description
Clinical Appeals Nurse - Full Time Remote - Jefferson Health
Articulates the job's main responsibilities. This is not intended to be an exhaustive list of all essential functions or all duties performed. The essential functions listed below and percentage of time may vary between departments and locations, and are subject to change based on management discretion and organizational needs. Other responsibilities may be assigned at the discretion of management to meet organizational needs.
Qualifications:
The requirements listed below are representative of the knowledge, skill, and/or ability required or preferred.
Education - Required
Experience - Required
Knowledge, Skills and Abilities - Required
Licenses and Certifications - Required
Work Shift
Workday Day (United States of America)
Worker Sub Type
Regular
Employee Entity
Thomas Jefferson University
Primary Location Address
1101 Market, Philadelphia, Pennsylvania, United States of America
Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.
Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.
Benefits
Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.
For more benefits information, please click here
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 external third-party payors to appeal denied claims. Works closely with Physician advisor team to facilitate appeals to payors. Monitors and reports payor trends to management team.
Job Description
Clinical Appeals Nurse - Full Time Remote - Jefferson Health
Articulates the job's main responsibilities. This is not intended to be an exhaustive list of all essential functions or all duties performed. The essential functions listed below and percentage of time may vary between departments and locations, and are subject to change based on management discretion and organizational needs. Other responsibilities may be assigned at the discretion of management to meet organizational needs.
- Creates an appeal letter to uphold the procedure based on medical policy guidelines of the payor and the documentation found in the hospital/physician information system.
- Facilitates write off accounts that cannot provide adequate medical necessity or documentation for the payor to meet their guidelines.
- Investigates and coordinates completion of patient records required to retrospectively precertify accounts and appeal insurance denials.
- Contacts insurance companies and conducts appeals via telephone or email.
- Coordinates appeals that need a physician's input for the payor and writes off claims that have no further appeal rights.
- Identifies areas for revenue loss due to documentation or processes not being reimbursable thru payors.
- Ensures that all appeals are sent to the correct payor within the appeal guidelines.
- Ensures compliance with regulatory and accrediting requirements.
- Reviews claim documentation and pulls supporting medical documentation from the system to support the medical policy guidelines of the payor.
- Searches for supporting clinical evidence to support appeal arguments when existing resources are unavailable.
Qualifications:
The requirements listed below are representative of the knowledge, skill, and/or ability required or preferred.
Education - Required
- Bachelor's Degree Nursing or
- Specialized Diploma
Experience - Required
- 10 years of clinical or case management/utilization review experience
Knowledge, Skills and Abilities - Required
- Ability to read medical charts and identify deficiencies in documentation content.
- Ability to adapt to ongoing changes within the health insurance industry in order to effectively implement positive changes.
- Knowledge of Interqual/medical policy criteria, case management principles, utilization review, and hospital departmental procedures.
- Knowledge of coding for payment of claims.
- Insurance knowledge of payors and their unique rules.
- Epic workflow experience with notes in account history and WQ workflows.
- Intermediate Excel and MS Word experience.
- Must complete RCE Training and pass test with 80% or better.
Licenses and Certifications - Required
- RN - Licensed Registered Nurse_PA - State of Pennsylvania
Work Shift
Workday Day (United States of America)
Worker Sub Type
Regular
Employee Entity
Thomas Jefferson University
Primary Location Address
1101 Market, Philadelphia, Pennsylvania, United States of America
Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.
Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.
Benefits
Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.
For more benefits information, please click here
What Jefferson Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Jefferson Health
Sourced by ZipRecruiter
Jefferson Health is a revered name in the healthcare sector, based in Philadelphia, Pennsylvania, US. This nonprofit health system is dedicated to delivering high-quality, compassionate clinical care and services across the region. The organization was founded in 1824 as Jefferson Medical College, and over the years, it has grown into a vast network of physicians and specialists, hospitals, outpatient and urgent care facilities. Offering a comprehensive range of healthcare services, Jefferson Health covers areas including cancer care, neuroscience, orthopedics, and cardiovascular care, among others. The organization's mission is to improve lives by promoting overall health and wellness, emphasizing value-based care, and making innovative medical advancements. Besides, one of their notable achievements includes being recognized by the National Academy of Medicine as a national leader in patient safety improvements.
Industry
Hospitals and health care and social assistance
Company size
10,000+ Employees
Headquarters location
Philadelphia, PA, US