- 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 ...monotony. EDUCATION: Graduate of an accredited professional nursing program. Registered nurse with current license to practice… more
- CommonSpirit Health Mountain Region (Centennial, CO)
- …resources to help you flourish and leaders who care about your success. The Denials Management RN is responsible and accountable for receiving, processing ... and documenting all concurrent denials for assigned facilities. The Denials Management RN has an integral role within the revenue cycle by providing… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview Director of Clinical Denials Management and Audit supervises a team of RN /LPN clinical reviewers as well as ... for all payor types striving to minimize lost revenue. Conducts analysis on denials and appeals and identifies trends that present process improvement and revenue… more
- UNC Health Care (Goldsboro, NC)
- …work activities. Responsibilities: 1. Provides leadership, clinical expertise and organization to the Denials Management Team. 2. Stays up to date and proactive ... Minimum 3-5 years of applied clinical experience as a Registered Nurse required. * 2 years utilization...or compliance experience preferred. * Minimum 1 year clinical denials management preferred. Knowledge, Skills and Abilities… more
- R1 RCM (Salt Lake City, UT)
- …Denials Manager** , you will serve as an expert on clinical appeals and denials management . Every day you will support client hospitals where claims were ... documentation. + Develop and maintain policies and procedures for denials and appeals management , ensure adherence to...to optimize the revenue cycle. **Preferred Skills:** + Active RN license preferred For this US-based position, the base… more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …AND EXPERIENCE** BSN (Bachelor of Science in Nursing) Minimum 5 years clinical experience as Registered Nurse ( RN ) Minimum 2 years managed care or equivalent ... MINIMUM KNOWLEDGE, SKILLS, ABILITIES AND TRAINING** Demonstrated experience in utilization management and denials management . Ability to understand… 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
- UCHealth (Denver, CO)
- …/Professional Nursing program if less than 3 years experience. + CO State licensure as a Registered Nurse ( RN ). + 3 years of clinical experience as a ... opportunity but you must reside in Colorado. Department: UCHlth Denials Management Payer Audit FTE: Full Time,...Responsibilities: + Writes clinical appeals to payors to recover denials . Coordinates with payors to conduct RN … more
- University of Miami (Miami, FL)
- …the revenue cycle department to ensure denial prevention and to analyze causes of denials , while assisting with denials management and ensuring financial ... or other relevant field. Certification and Licensing: Valid State of Florida Registered Nurse license or Florida Licensed Clinical Social Worker Experience:… more
- Northwell Health (Melville, NY)
- …five (5) years of job entry date. + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as ... needed. + Prior experience in Case Management , Utilization Review, and Appeals/ Denials , highly preferred. *Additional Salary Detail The salary range and/or… 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
- Ellis Medicine (Schenectady, NY)
- …assist in utilization management activities under the direction of a registered nurse and/or social worker. Responsibilities include maintaining case files, ... Social Worker, Nurse Case Manager, or Utilization Management Nurse to facilitate patient discharge plans,...UM Coordinator with data entry of insurance authorizations and denials . + Denial Management Activities + Assists… more
- AdventHealth (Daytona Beach, FL)
- …or RN Diploma degree + State of Florida license as a Registered Nurse + Two (2) years of medical/hospital nursing experience **Preferred qualifications:** ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- Geisinger (Scranton, PA)
- …Experience Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE ... of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through… more
- Prime Healthcare (Aurora, IL)
- …status and continued stay reviews. Communicates all medical necessity review outcomes and denials to case management staff and providers. Engage in denial ... or payer setting within the last 5 years. 2. Utilization review and denial management experience required. 3. Current state RN licensure required. 4. Must be… more
- Houston Methodist (The Woodlands, TX)
- …HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or ... of opportunities for appropriate utilization of resources to avoid denials and resource management as it pertains...Compact State Licensure within 60 days **OR** + RN -Temp - Registered Nurse -… more
- Ascension Health (Wamego, KS)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing ... **Details** + **Department:** Case Management + **Schedule:** Full time Day shift + **Hospital:** Ascension Via Christi + **Location:** Wamego Health Center, Wamego,… more
- AdventHealth (Orlando, FL)
- …experiences you'll need to succeed:** **EDUCATION AND EXPERIENCE REQUIRED:** + Associates Degree Nursing or RN Diploma degree + Registered Nurse ( RN ) + ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- HCA Healthcare (Houston, TX)
- …appropriate. **What qualifications you will need:** + Bachelor's degree Nursing preferred + Registered Nurse - Currently licensed as a registered ... any other healthcare provider. We are seeking a(an) Case Management Supervisor RN to join our healthcare...Support + Registered Social Worker (RSW), or Registered Nurse , or Certified Care Manager (CMC)… more