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Clinical Coordinator

Avanciers LLC

Remote or Hybrid in Florida City, Florida • Today

Easy Apply

Contract

Depends on Experience

Clinical Document Improvement Coordinator

Talent Groups

Remote • 6d ago

Easy Apply

Contract

47 - 57

Clinical Contracts Associate

Arnex Solutions LLC

Remote • Today

Full-time, Third Party

Depends on Experience

Senior Clinical Research Associate

EmployVision

Remote • Today

Easy Apply

Contract

$70 - $80

Clinical Quality Manager

The Davis Companies

Remote • 21d ago

Easy Apply

Full-time

Depends on Experience

Pharma Clinical Trial Operations Data Analyst / Business Analyst

Pantar Solutions, Inc.

Remote • 10d ago

Easy Apply

Contract, Third Party

Depends on Experience

Clinical Trial Lead

Motion Recruitment Partners, LLC

Remote or Warsaw, Indiana • Today

Easy Apply

Full-time

Clinical Services Project Manager I

Motion Recruitment Partners, LLC

Remote • Today

Easy Apply

Contract

Clinical Data Business Analyst :: Remote

Logisoft Technologies Inc

Remote • 8d ago

Easy Apply

Contract, Third Party

Depends on Experience

Clinical Data Analyst

Enterprise Engineering

Remote • 17d ago

Easy Apply

Contract

Clinical Study Administrator

Motion Recruitment Partners, LLC

Remote or Irvine, California • Today

Easy Apply

Contract

Clinical Data Management System(Veeva/Rave/ Elluminate/JReview) | Remote

Apetan Consulting

Remote • Today

Easy Apply

Contract, Third Party

$7 - $8

Product Owner with Clinical Exp @ W2

Cyber Sphere LLC

Remote • Today

Easy Apply

Contract

Depends on Experience

Senior RAVE Clinical Database Programmer

Katalyst Healthcares and Lifesciences

Remote or New Jersey • Today

Full-time

Clinical Medical Review Nurse

Charter Global, Inc.

Remote • 9d ago

Easy Apply

Third Party, Contract

Depends on Experience

Sr Clinical Data Management Associate

Gilead Sciences, Inc.

Remote • Today

Full-time

USD 115,260.00 - 149,160.00 per year

Product Owner with Clinical Experience-Remote

Cyber Sphere LLC

Remote • Today

Easy Apply

Contract

$40+

Role: AI & Analytics Engineer - Clinical Informatics

Digital Dhara LLC

Remote • 8d ago

Easy Apply

Contract, Third Party

50 - 60

Senior Rave Clinical Database Programmer

Katalyst Healthcares and Lifesciences

Remote or New York, New York • Today

Full-time

SENIOR TECHNICAL ARCHITECT CLINICAL IMAGING & AI/ML

Infinity Tech Group Inc

Remote • 13d ago

Easy Apply

Contract

Depends on Experience

Senior Associate, Clinical Data Standards Management (CDSM)

Gilead Sciences, Inc.

Remote • Today

Full-time

USD 123,930.00 - 160,380.00 per year

Production Coordinator

Talent Groups

Remote or Cincinnati, Ohio • 3d ago

Easy Apply

Contract

Clinical Database Programmer

Becton Dickinson & Company

Remote or Maryland • Today

Full-time

Project Manager, Regulatory Affairs (Clinical and CMC)

Mitchell Martin, Inc.

Remote • 28d ago

Easy Apply

Contract, Third Party

$49 - $70

Data Analyst, Clinical Analytics and Reporting

DaVita Inc.

Remote or Denver, Colorado • 30+d ago

Full-time

USD 57,784.00 - 85,000.00 per year

Principal Clinical Datawarehouse Programmer

BeiGene, Inc.

Remote • Today

Full-time

USD 125,000.00 - 165,000.00 per year

Senior Data Scientist - Clinical Informatics (Analytics Enablement)

CVS Health

Remote or New York, New York • Today

Full-time

USD 83,430.00 per year

IT Program Manager - Clinical Applications: Strategic Initiatives & AI

Advocate Health Care

Remote • Today

Full-time

USD 59.00 - 88.50 per hour

Clinical Development Consultant

Motion Recruitment Partners, LLC

Remote or Rochester, New York • Today

Easy Apply

Contract

Senior Consultant - GxP & Clinical Quality Assurance

Arthur Lawrence

Remote • 24d ago

Easy Apply

Contract, Third Party

$70 - $75

Job Details

Skills

Medical Records
Nursing
Medicare
ICD-10

Summary

Avanciers Incorporated is hiring a Clinical Coordinator for one of our clients.

Role: Clinical CoordinatorLocation: Florida / Remote (as applicable)Experience: 1–5 years of clinical nursing experienceRequired License: Active, unrestricted Florida RN License or Compact RN LicenseJob Description:

Reviews and investigates member and provider appeals involving clinical/medical necessity denials.
Analyzes medical records, claims history, and clinical documentation against InterQual/MCG criteria to determine appeal outcomes.
Ensures timely resolution in accordance with CMS, NCQA, Medicare, Medicaid, and state regulatory requirements.
Documents clinical rationale and coordinates with Medical Directors on complex cases.

Qualifications:

Active, unrestricted Florida RN License or Compact RN License
1–5 years of clinical nursing experience
1–2 years of experience in Utilization Review, Case Management, or Appeals/Grievances within a managed care/health plan setting
Strong knowledge of medical terminology and ICD-10/CPT coding basics
Experience with medical necessity review and InterQual/MCG criteria
Knowledge of CMS, NCQA, Medicare/Medicaid regulatory requirements

Good to Have ExperienceManaged Medicaid/Medicare Advantage experience; prior health plan UM/UR background; experience with appeal turnaround SLAs

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 91094911
Position Id: 9109431
Posted 12 hours ago

Fitment

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Contact the job poster

Pranav Seth

Recruiter @ Avanciers LLC

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RN Clinical Auditor - Behavioral Health

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RN Clinical Auditor - Behavioral HealthLocation: Fully Remote, with occasional travel to Downtown Indianapolis, IN (expenses covered)Job Summary:We are seeking a Registered Nurse Clinical Auditor with extensive Behavioral Healthexperience to support medical record reviews and billing compliance audits for the Indiana Health Coverage Programs (IHCP). This role evaluates quality of care, reviews medical records and program policies, identifies compliance issues, prepares audit documentation and re

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Certified Medical Coder/Medical Record Audit Specialist - Behavioral HealthLocation: Fully Remote, with occasional travel to Downtown Indianapolis, IN (expenses covered)Job Summary:We are seeking aCertified Medical Coder/Medical Record Audit Specialistwith strongBehavioral Healthcoding experience to support a state Medicaid program engagement. This role focuses on auditing medical records and claims documentation for coding accuracy and compliance, identifying billing and documentation issues, a

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Medicare Appeals Professional with Licensed nurse

Remote

•

29d ago

Responsibilities:Reviews medical records/case file, writes a reconsideration decision letter that is clear, concise, andimpartial and supports the determination made, and documents review.Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation,rulings, and policy.Responds to and ensures that all appeal issues raised by the beneficiary/patient, representative, andprovider/supplier have been addressed.Provides a fair and impartial decision based on curr

Easy Apply

Full-time

Depends on Experience

Documentation Integrity Analyst

Remote

•

Today

Job Title: Documentation Integrity Analyst Hourly/Salary Compensation Range: $30-35 Contract Length: 6 months Location: Remote Hours: 8-4:30 CT Start Date: 10/26/26 Job Summary The Revenue Integrity Analyst is responsible for performing specialized second-level review of medical records for vascular and other assigned high-risk services. The role evaluates clinical documentation, coding requirements, and payer coverage criteria to determine whether the medical record supports the ordered s

Contract

$30.00 - $35.00

Job Details

Skills

Medical Records
Nursing
Medicare
ICD-10

Summary

Avanciers Incorporated is hiring a Clinical Coordinator for one of our clients.

Reviews and investigates member and provider appeals involving clinical/medical necessity denials.
Analyzes medical records, claims history, and clinical documentation against InterQual/MCG criteria to determine appeal outcomes.
Ensures timely resolution in accordance with CMS, NCQA, Medicare, Medicaid, and state regulatory requirements.
Documents clinical rationale and coordinates with Medical Directors on complex cases.

Qualifications:

Active, unrestricted Florida RN License or Compact RN License
1–5 years of clinical nursing experience
1–2 years of experience in Utilization Review, Case Management, or Appeals/Grievances within a managed care/health plan setting
Strong knowledge of medical terminology and ICD-10/CPT coding basics
Experience with medical necessity review and InterQual/MCG criteria
Knowledge of CMS, NCQA, Medicare/Medicaid regulatory requirements

Good to Have ExperienceManaged Medicaid/Medicare Advantage experience; prior health plan UM/UR background; experience with appeal turnaround SLAs

Dice Id: 91094911
Position Id: 9109431
Posted 12 hours ago

Fitment

Dice Job Match Score™

To see how well you match this job, please log in or create an account.

Once logged in, be sure to complete your profile to get the most accurate match score.

Contact the job poster

Pranav Seth

Recruiter @ Avanciers LLC

View Profile

Create job alert

Never miss an opportunity! Create an alert based on the job you applied for.

Similar Jobs

RN Clinical Auditor - Behavioral Health

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Medicare Appeals Professional with Licensed nurse

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Documentation Integrity Analyst

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$30.00 - $35.00