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Clinical Appeals Reviewer

New York,NY

2381 Clinical Appeals Reviewer jobs in New York,NY

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Customer Care Advocate (Remote)

Hire Standard Staffing

New York, NY

$120,000/yr
RemoteHealth Insurance

  • Must be a U.S. or Canadian citizen
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Quality Management Nurse / RN

RCM Healthcare Services

Brooklyn, NY 11234

$110,000/yr
~ 26 min OnsiteEducation AssistancePaid Time Off

  • Active New York State RN license
  • Minimum of 3–5 years of experience in home health quality management or compliance.
  • Comprehensive knowledge of CHHA regulations and applicable federal, state, and Department of Health (DOH) requirements.
  • Strong understanding of Medicare Conditions of Participation (CoPs) for home health, including documentation, visit frequency, and billing compliance.
  • Experience conducting clinical record reviews for accuracy, completeness, and compliance with regulatory standards
  • Familiarity with OASIS data collection, quality reporting, and reimbursement processes.
  • Demonstrated ability to analyze quality metrics, identify performance trends, and drive quality improvement initiatives.
  • Hands-on experience with survey readiness, audits, and interactions with regulatory agencies such as OMIG, CMS, or DOH.
  • Proficiency in Electronic Medical Record (EMR) systems, preferably HCHB or similar platforms.
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Clinical Supervisor, 7-31-2026

Hourchildren.org

Astoria, NY 11106

$90,000/yr
Hybrid~ 12 minFlexible Schedule

  • Licensed in NYS -LCSW
  • 5 years' experience supervising staff serving justice-impacted populations who have experienced complex trauma
  • Must be able to deliver services in a culturally sensitive manner centering justice, equity, diversity, and inclusion
  • Must be able to work independently and as part of a team and be on call for client emergencies
  • Computer and technical skills, specifically Microsoft Office programs
  • Experience with navigating public benefits, substance use treatment systems, and/or supportive housing programs
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New, Posted 22 hours ago
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Admission Nurse

Metropolitan Jewish Health System

Brooklyn, NY 11201

$15,000 bonus
New, Posted 1 day ago
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Clinical Success Director - Northeast Region

B. Braun Medical

New York, NY 10001

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Healthcare Liability Nurse Consultant

Gallagher Bassett

New York, NY 10017

Remote

  • Bachelor's degree in Nursing (BSN) or equivalent; Registered Nurse (RN) license or similar level healthcare licensing required.
  • Minimum of 5 years of clinical experience.
  • Must have proficient knowledge of medical malpractice and personal injury law.
  • Strong knowledge of medical terminology, healthcare regulations, and legal procedures.
  • Excellent research and analytical skills, with the ability to interpret complex medical information and apply it to legal cases.
  • Proficient in using medical research databases, electronic medical record systems, and legal research tools.
  • Excellent written and verbal communication skills, with the ability to effectively communicate complex medical concepts to claims handling professionals, attorneys and other team members.
  • Proficient in using Microsoft Office Suite (Word, Excel, PowerPoint).
  • Ability to create and complete comprehensive, accurate and constructive written reports.
SmartExplore AI is experimental.
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New, Posted 3 hours ago
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Patient Services Assistant

Veterans Health Administration

Bronx, NY 10467

ZipRecruiter

Inpatient Coding Expert - Fully Remote | Upto $150/hr

Mercor

New York, NY 10025

$150/hr
Remote
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Medical Science Liaison - Northeast

SK Life Science

Paramus, NJ 07652

New, Posted 1 day ago
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Clinical Director

JAG Physical Therapy

Bronx, NY 10462

$7,500 bonus
~ 17 min OnsiteEducation AssistanceHealth InsurancePaid Time OffRetirement Benefit

  • Bachelors or Masters Degree required
  • Professional License/Certification required
  • Valid CPR license
  • Minimum of three years' clinical outpatient experience
  • Knowledge of EMR system
SmartExplore AI is experimental.
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  1. New York,NY Jobs
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  3. Clinical Appeals Reviewer Jobs

What companies are hiring Clinical Appeals Reviewer jobs in New York,NY?

  1. Hire Standard Staffing
  2. RCM Healthcare Services
  3. Hourchildren.org
  4. Metropolitan Jewish Health System
  5. B. Braun Medical
  6. Gallagher Bassett
  7. Veterans Health Administration
  8. Mercor
  9. SK Life Science
  10. JAG Physical Therapy

What is the hourly salary range for Clinical Appeals Reviewer jobs in New York,NY?

The hourly salary range is $150 - $150.

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