- CDPHP (Albany, NY)
- …values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal and grievance ... more
- Healthfirst (PA)
- …Reduction, Termination, and Suspension of services. The end-to-end process requires the Specialist to independently: + Research issues + Quality of Care Experience + ... more
- Catholic Health (Buffalo, NY)
- …as related to DRG and level of care denial trends. Responsibilities: EDUCATION + Registered Nurse with a current New York State license + Bachelor of ... more
- Rochester Regional Health (Rochester, NY)
- …focused denials from external payers and their contractors. The Clinical Denial Specialist writes and submits professionally written appeals which include ... more
- State of Colorado (CO)
- CDOC Registered Nurse ( Nurse I) Print...RN license. 07 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... more
- State of Colorado (Sterling, CO)
- CDOC Registered Nurse - Part-time - Sterling Print...Yes + No 06 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... more
- Molina Healthcare (Tacoma, WA)
- …business need) Unrestricted RN licensure **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously ... more
- Molina Healthcare (Covington, KY)
- … appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of ... more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... more
- Baptist Memorial (Memphis, TN)
- Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary The Denial Mitigation-Appeal Specialist II RN ... more
- Baptist Memorial (Memphis, TN)
- Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary The Denial Mitigation-Appeal Specialist II RN ... more
- Fairview Health Services (St. Paul, MN)
- **Job Overview** **Join Our Team at Fairview as a Utilization Management Specialist RN - 100% Remote!** _Help shape patient care and outcomes, from the comfort ... more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and tracks ... more
- University of Washington (Seattle, WA)
- …+ Minimum of 6 years of experience in an acute inpatient hospital setting as a registered nurse , with in-depth knowledge of medical and surgical care. ER or ICU ... more
- City and County of San Francisco (San Francisco, CA)
- …and Certification: + Registered Nurse License: Possession of a valid California Registered Nurse ( RN ) license issued by the California Board of ... more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Pharmacy, Public Health, Epidemiology, Biostatistics, Genetics, Health Technology). (Required) + Registered Nurse , Physician's Assistant, or Nurse ... more
- Corewell Health (Southfield, MI)
- …required in an acute inpatient hospital setting. 1 of 4 Certification required + LIC- Registered Nurse ( RN ) - STATE_MI State of Michigan. + LIC-Physician ... more
- Trinity Health (Des Moines, IA)
- …health administration or related field required. + Iowa licensure as a Registered Nurse . + Member of a professional healthcare organization.Demonstrated ... more
- Trinity Health (Des Moines, IA)
- …in nursing, health administration or related field required. + Iowa licensure as a Registered Nurse . Experience: Requires a minimum of three (3) years in ... more
- Independent Health (Buffalo, NY)
- … Health Information Technician (RHIT), Certified Clinical Documentation Specialist (CCDS), American Health Information Management Association (CCS-H, CCS-P), ... more