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St. Luke's University Health Network
Overview
The RN Clinical Review Appeals Specialist conducts retrospective reviews of patient medical records and claims data to ensure accurate coding and DRG assignment. They develop appeal arguments and facilitate communication with various stakeholders to resolve documentation and coding issues.
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Compensation
Salary not listed
Posted
7 days ago
PacificSource
This role supports the mission by coordinating pharmaceutical services based on member circumstances, benefits, and available resources, while providing subject matter expertise for specialized pharmacy processes like formulary administration or quality initiatives. Essential duties include collaborating with leadership to strategically improve processes, leading clinical meetings, assisting with training, and staying current on relevant State and Federal regulations.
$113,520 - $198,660 / YEAR
3 months ago
