- Dayton Children's Hospital (Dayton, OH)
- Facility:Work From Home - OhioDepartment:Utilization Review TeamSchedule: Full timeHours:40Job Details:Reporting to the Manager of Utilization Management and in ... and Resource Management; supports the development and implementation of a comprehensive denials management program. This role functions as a hospital liaison with… more
- WellSpan Health (York, PA)
- …and Denials Management Location: WellSpan Health, York, PA Schedule: Full Time General Summary Supervises and oversees the operations of the utilization ... Responsibilities + Oversees the utilization management process for preauthorization, concurrent review, denials and appeals for System acute care facilities. +… more
- Insight Global (Skokie, IL)
- Job Description Insight Global is looking for a clinical denials specialist to join the team at one of your healthcare clients in Chicago. As a Clinical Denials ... the denials team to review and analyze denials from a clinical perspective. This person will be...clinical perspective. This person will be responsible for preparing appeals and communication with the clinical team members. With… more
- BronxCare Health System (Bronx, NY)
- Overview Assists in the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute ... improve outcomes. - Maintains an excel log related to denials / appeals activities in order to monitor successful...Regular Full -Time Division Bronxcare- Yonkers Max USD $97,125.00/Yr. Shift Day Shift Department : Name Appeals Department… more
- Carle (Urbana, IL)
- Outpatient Denial/ Appeals Specialist- RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + Employment ... Type: Full - Time + Job ID: 44345 + Experience...Weekend Requirements: no + Other Posting Information: Registered Professional Nurse (RN) License Illinois upon hire. + Holiday Requirements:… more
- Stanford Health Care (Palo Alto, CA)
- …criteria and guidelines to optimize patient outcomes and manage healthcare costs. 4. Denials and Appeals Management: Address and manage denials by ... Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN) will be responsible for ensuring the efficient and effective… more
- Nuvance Health (Danbury, CT)
- …leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff while partnering with ... Leader* will be responsible for leading a team encompassing utilization review and denials / appeals specialists and will need to foster a culture of… more
- HCA Healthcare (Houston, TX)
- …criteria and against established critical pathways. + Reviews and, if necessary, appeals Medicare/Medicaid and Managed Care denials . + Monitors for ... Health Assistance Fund that offers free employee-only coverage to full -time and part-time colleagues based on income. Learn more...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
- Glens Falls Hospital (Glens Falls, NY)
- …charge discrepancies, CCI edits, and charge review * Serve as a clinical resource for appeals and denials * Review/update of Charge Master * Monitor and reports ... is seeking a strategic, forward thinking, and motivated Registered Nurse with leadership experience to join as our next...summary of these offerings, which are available to active, full -time and part-time employees who work at least 30… more
- Ascension Health (Manhattan, KS)
- …related to coding, medical records/documentation, precertification, reimbursement and claim denials / appeals . + Assess and coordinate discharge planning needs ... **Details** + **Department:** Utilization Management + **Schedule:** Full Time, 40 hours weekly, Monday - Friday 7:30am - 4pm + **Hospital:** Ascension Via Christi… more
- PeaceHealth (Vancouver, WA)
- …matter content expert and change agent with in-depth knowledge of workflow related to denials and appeals management. Performs in depth reviews of clinical DRG ... a RN Clin Doc Integrity Specialist/Denial Reviewer for a Full Time, 1.00 FTE, Day position. The salary range...downgrade denials to draft appeal letters for submission to payers.… more
- Billings Clinic (Billings, MT)
- …Benefits We provide a comprehensive and competitive benefits package to all full -time employees (minimum of 24 hours/week), including Medical, Dental, Vision, 403(b) ... Billings Clinic (Billings Clinic Main Campus) req8271 Shift: Day, Weekends Employment Status: Full -Time (.75 or greater) Hours per Pay Period: 1.00 = 80 hours… more
- Mount Sinai Health System (New York, NY)
- …Shares denial data with physicians and collaborates on strategies to reduce denials . Works collaboratively with the Medical Centers Appeals Management Program. ... Masters preferred + 5 years case management and 6 years as clinical nurse . Previous supervisory experience in case management or related field. + Name: Current… more
- Alameda Health System (San Leandro, CA)
- San Leandro Hospital Case Manager RN, Full Time, Benefited, Days, 8hrs, 1.0fte + San Leandro, CA + San Leandro Hospital + SLH Social Services + Full Time - Day + ... contacts with payers conducting phone reviews and initiates denial appeals as needed. 3. Encourages patients to develop realistic...action when cases do not meet criteria - coordinates denials with the attending physician, and the UR physician… more
- Cleveland Clinic (Vero Beach, FL)
- …clinical information to the payer, UM data collection and reporting, concurrent denials appeals process, clinical team interaction, Physician Adviser interaction ... clinical information to payers, UM data collection and reporting, concurrent denials appeals process, clinical team interaction, Physician Adviser interaction… more
- TEKsystems (Raleigh, NC)
- …* Account Manager serves as the member of the Corporate Coding Team by reviewing denials and appeals for coding related issues * Reviews daily Epic work queues ... * Need to have billing experience, knowledge of inpatient AND outpatient (DRG, denials , claims, appeals ), experience with the hospital setting and hospital… more
- Virtua Health (Mount Laurel, NJ)
- …open communication with management regarding billing and coding issues including documentation, denials / appeals , etc. * Follows up on assigned insurances on a ... over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques… more
- Providence (Mission Hills, CA)
- …experience may consider in lieu of acute care + Previous experience working with denials and appeals in/for an acute care setting + Previous experience working ... California Region. The Manager assists the Regional Director of Utilization Management, Appeals & Clinical Training through the provision of ongoing assessment and… more
- UNC Health Care (Chapel Hill, NC)
- …progression + Protects hospital revenue by working with payors for insurance authorizations, denials , and appeals + 40 hrs/week with flexible schedule options ... team, third party payors and resource center. Provides information regarding denials and approvals to designated entities. Assists in coordination of practice… more
- Hackensack Meridian Health (Perth Amboy, NJ)
- …workflows for utilization review activities including admission reviews, admission denials , continued stay reviews, continued stay denials , termination ... information to insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record utilization reviews. + Obtains and… more