Back to all jobs

LVN Lead Clinical Appeals Nurse

Work from home Full-time role Hiring

We are looking for an experienced and passionate LVN Lead Clinical Appeals Nurse to join the Molina Healthcare team. In this role, you will have the opportunity to be a part of a dedicated team of professionals that is committed to providing quality healthcare for our members. The ideal candidate will be experienced in healthcare appeals management, possess excellent communication skills, and be a team player. If you are looking to join an innovative and progressive organization that is focused on improving the lives of our members, we want to hear from you!Required Qualifications:• Current, unrestricted LVN license in the state of California

  • At least 5 years of experience in healthcare appeals management• Proven track record of achieving successful appeals outcomes• Experience with managed care and/or government funded programs• Ability to communicate effectively and work collaboratively with staff and other healthcare providers• Ability to multitask and remain organized in a fast-paced environment• Knowledge of medical terminology and coding• Strong computer skills, including experience with Microsoft Office and EMR software

Responsibilities: Manage healthcare appeals process for Molina Healthcare members. Communicate effectively with staff and other healthcare providers. Accurately document appeals outcomes in EMR software. Maintain current, unrestricted LVN license in the state of California. Utilize knowledge of medical terminology and coding to accurately process appeals. Remain organized and multitask in a fast-paced environment. Utilize strong computer skills, including experience with Microsoft Office. Collaborate with staff and other healthcare providers to ensure successful appeals outcomes. Stay up-to-date with healthcare regulations and guidelines. Provide guidance and training to other staff members on appeals management. Molina Healthcare is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Apply tot his job Apply To this Job

Related remote jobs

Nurse - LPN/LVN - AL, GA, KY, MS, or TN licensure required

Work from home Full-time role

Senior Manager, Clinical Nurse Educator – Sickle Cell Disease - Remote

Work from home Full-time role

Practical Nursing Adjunct Instructor – Virtual Didactic (Evenings)

Work from home Full-time role

Nurse Educator – Clinical Development Nurse I (Case Management ) Seattle/Bellevue/Everett/Renton

Work from home Full-time role

Certified Nursing Assistant (PRN ONLY)

Work from home Full-time role

Clinical Content Specialist - Nursing (Integration Nurse Educator/Traditional Programs)

Work from home Full-time role

Nurse Navigator – Home Health to Hospice Transition

Work from home Full-time role

Medical Review Nurse II – Commerical Home Health

Work from home Full-time role

Registered Nurse Navigator – Medical Oncology Clinic – RN *Hybrid*

Work from home Full-time role

[Hiring] Clinical Trial Nurse Navigator @Blood Cancer United

Work from home Full-time role

NJ Devils Reporter & Youtube Host

Work from home Full-time role

Experienced Customer Engagement Manager – Crafting Unforgettable Experiences for arenaflex Customers

Work from home Full-time role

Senior Threat Intelligence Analyst, Crypto

Work from home Full-time role

Family Nurse Practitioner - Per Diem - Evernorth - Towson MD

Work from home Full-time role

Storyboard/Animatics Artist

Work from home Full-time role

Remote Data Entry Specialist – $19/Hour No Experience Required

Work from home Full-time role

Corporate AML/BSA Investigator

Work from home Full-time role

Experienced Part-Time Remote Live Chat Specialist – Customer Service Representative | Entry-Level | Earn $20-$25/hr | Work from Home

Work from home Full-time role

Customer Support Engineer (Remote) - Beginner Friendly IT Job

Work from home Full-time role

Experienced Full Stack Data Entry Specialist – Remote Customer Service and Data Management

Work from home Full-time role