- CHRISTUS Health (Wake Village, TX)
- Description Summary: The Registered Nurse Clinical Care Coordinator is responsible for evaluating, coordinating, processing, screening, and documentation of ... patient entry into the CHRISTUS Health System. The Registered Nurse Clinical Care Coordinator will collaborate with relevant providers and partners to determine… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials ... JOB DUTIES AND RESPONSIBILITIES: + Reviews all Inpatient Retroactive Denials in the Denials Management ...an accredited, professional nursing program. + Must have current RN license to practice in the state of Pennsylvania… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …role within the revenue cycle by providing clinical expertise in the denials management process. The Denials RN performs a root cause analysis of ... assigned by the manager. **Qualifications** **Required:** + Minimumthree (3)yearsclinical experience as Registered Nurse ( RN ) required. + Graduation from an… more
- Dayton Children's Hospital (Dayton, OH)
- …Coaching Skills preferred Education Requirements: Bachelors: Nursing (Required) Certification/License Requirements: [Lic] RN : Registered Nurse ( RN ) - ... ; supports the development and implementation of a comprehensive denials management program. This role functions as...Completion of accredited BSN program required Certifications + Licensed Registered Nurse in Ohio required + Current… more
- R1 RCM (Boise, ID)
- …Denials Manager** , you will serve as an expert on clinical appeals and denials management . Every day you will support client hospitals where claims were ... to escalate trends, challenges, and process improvement opportunities. **Required Skills:** + Registered Nurse (active or inactive in good standing and able… more
- Stanford Health Care (Palo Alto, CA)
- …an onsite Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN ) will be responsible for ensuring the ... health record (EHR) systems and other healthcare software. **Licenses and Certifications** + Nursing/ RN - Registered Nurse - State Licensure and/or Compact… more
- Premier Health (Dayton, OH)
- DEPT: CLINICAL DENIALS ADMIN Full-Time / DAY SHIFT The Denials Management Clinical Analyst (DMCA) is a registered professional nurse with knowledge ... Manage projects assigned by department leadership 15. Defines opportunities to improve denials management processes and department performance. Minimum Level of… more
- Nuvance Health (Danbury, CT)
- …in nursing, health administration, or a related field preferred * Current licensure as a registered nurse ( RN ) * Minimum of 5 years of clinical experience ... and strategy for system-wide care coordination, encompassing utilization review (UR), denials management , discharge planning, social work, and non-clinical… more
- Trinity Health (Springfield, MA)
- …program. BSN graduate preferred, Master's preferred + **Licensure** : Current Licensure as a Registered Nurse RN in Massachusetts. + **Certification** : BLS ... determinations using screening criteria, and assists the physician, bedside Registered Nurse , ICC and Social Worker with utilization management and clinical… more
- Penn Medicine (Plainsboro, NJ)
- …nursing (MSN) or another related healthcare field - preferred + Registered Nurse - NJ (Required) + Case Management certification preferred; or obtains within ... clinical management of the continuum of care process, length of stay, denials management , and status of patients. The Director serves as the primary point of… more
- Henry Ford Health System (Detroit, MI)
- …and exceptional business performance. Role also includes payer collaboration and denials management including oversight of documentation requests both pre ... long and short-term strategic goals of the department with the assistance of the management team. Ensures staff is aligned with the goals and objectives related to… more
- McLaren Health Care (Bay City, MI)
- …and Responsibilities as Assigned:** 1. Supports activities consistent with Integrated Care Management Denials across all MHC subsidiaries. 2. Accountable for ... responsibilities of the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer appeal/filing deadlines are met and… more
- Alameda Health System (Oakland, CA)
- …completion of financial analyses including cost of care to reimbursement, denials management , and non-reimbursed services, promoting effective resource ... Director, Inpatient System Care Management + Oakland, CA + Highland General Hospital...Preferred Experience: N/A Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California… more
- Stanford Health Care (Palo Alto, CA)
- …and Certifications** + One of the following active certifications required: + CA - RN ( Registered Nurse ) license, or + Physical Therapist Licensed Applicant ... preferred + Knowledge of admission criteria for all levels of care and denials management + Knowledge of case management principles, processes, and their… more
- Trinity Health (Pontiac, MI)
- …medical record. 10 Participates in the appeal process when deemed necessary by the Denials Management Specialist on cases where payment has been denied. **Our ... Degree in Nursing preferred . **B.** **Licensure / Certification** Current RN licensure within the State of Michigan. Certified Professional in Utilization… more
- Tufts Medicine (Burlington, MA)
- …**Job Description** **Minimum Qualifications:** 1. Bachelor's Degree in Nursing 2. Active Registered Nurse ( RN ) license in Massachusetts or compact ... setting (ICU, ED, Critical Care, strong Med/Surg Specialty) or equivalent case management , utilization review, denials management , or progressive leadership… more
- Banner Health (AZ)
- …If you're looking to leverage your abilities - apply today. The Registered Nurse RN Denial Management Specialist is responsible for reviewing concurrent ... this position interacts with RAC Auditors and other organizations. MINIMUM QUALIFICATIONS Requires Registered Nurse ( RN ) licensure in the state of practice.… more
- Omaha Children's Hospital (Omaha, NE)
- …**Licenses and Certifications** + LCSW- Licensed Clinical Social Worker Upon Hire Required or + RN - Registered Nurse - State Licensure and/or Compact State ... align clinical services with revenue capture and expense avoidance, including denials management , to achieve the highest level of clinical and financial… more
- AdventHealth (Orlando, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- Geisinger (Bloomsburg, PA)
- …Experience Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic Life ... of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through… more
