- 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 Specialist you will be working with...and Requirements 3+ years experience as a utilization review nurse Experience reviewing and analyzing denied claims Knowledge of… more
- St. Luke's University Health Network (Allentown, PA)
- …near vision, visual monotony. EDUCATION: Graduate of an accredited professional nursing program. Registered nurse with current license to practice in the state ... serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical… 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 hourly… more
- Community Health Systems (Franklin, TN)
- …3 plus years Utilization review experience + Required License/Registration/Certification: Licensed Practical Nurse or Licensed Registered Nurse + Preferred ... and/or corporate policies/procedures. + In the event of concurrent denials , the UR Clinical Specialist reviews the denial and works with the physicians on… more
- MaineGeneral Health (Waterville, ME)
- …to our patients and their families. MaineGeneral Hospice is currently seeking an experienced Registered Nurse ( RN ) for a 32-40 hour per week position. ... The Hospice Quality Specialist ensures that patient care services are delivered in...candidate will have: + A current license as a Registered Nurse in Maine or licensed from… 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:** ... Medical Parkway, Daytona Beach, FL 32117 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
- AdventHealth (Orlando, FL)
- …experiences you'll need to succeed:** **EDUCATION AND EXPERIENCE REQUIRED:** + Associates Degree Nursing or RN Diploma degree + Registered Nurse ( RN ) + ... Annual number of emergency cases: 89,018 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses,… more
- HonorHealth (Scottsdale, AZ)
- …1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required ... more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of...accredited NLN/CCNE institution Required Experience 3 years as a Registered Nurse in an acute care setting… more
- Community Health Systems (Franklin, TN)
- …and feedback to related departments as needed. + Track and manage clinical denials using current tools (manuals, training programs). + Identify patterns and trends ... in denials ; communicate to appropriate persons. + Maintain documentation regarding...of clinical nursing experience. + **Certificates and Licenses:** Current RN license to practice in state **Preferred** + Utilization… more
- AdventHealth (La Grange, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- WellSpan Health (Ephrata, PA)
- …documentation specialist in an inpatient acute care facility. Required Licenses: + Licensed Registered Nurse Upon Hire Required or + Registered Nurse ... Clinical Documentation Integrity Specialist II - Day Location: WellSpan Health, Ephrata,...Licensed Physician Assistant Upon Hire Required or + Certified Registered Nurse Practitioner Upon Hire Required and… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …experience is preferred. + **Certification/Licensure/Registration:** + Licensed as a Registered Nurse in the Commonwealth of Massachusetts preferred. ... molecular pathology, high-cost drug, and off-label drug authorizations. The Clinical Authorization Specialist is also responsible for managing denials related to… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Clinical Documentation Integrity Specialist Full-Time, 80 Hours per pay period, Day Shift Covenant Health Overview: Covenant Health is the region's ... be named a Forbes "Best Employer" seven times. Position Summary: The CDI Specialist serves as liaison between the physicians and hospital departments to promote… more
- Granville Medical Center (Oxford, NC)
- …of CDI. Required: Graduation from a Board-approved nursing program with current licensure as a Registered Nurse ( RN ) or Licensed Practical Nurse (LPN) in ... Summary : The CDI Specialist is responsible for improving the overall quality...Present on Admission indicators. * Obtains documentation relevant to denials avoidance related to the Recovery Audit program, the… more
- Granville Health System (Oxford, NC)
- …of CDI. Required:# Graduation from a Board-approved nursing program with current licensure as a Registered Nurse ( RN ) or Licensed Practical Nurse (LPN) ... Summary:#The CDI Specialist is responsible for improving the overall quality...of Present on Admission indicators. #Obtains documentation relevant to denials avoidance related to the Recovery Audit program, the… more
- Alameda Health System (San Leandro, CA)
- …at a medical group or health plan. Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California, Active BLS - Basic Life ... Care Management Clinical Appeals Specialist + San Leandro, CA + Finance +...based on identified criteria and ensures the patient is registered at the appropriate level of care; Utilizes McKesson… more
- Project Renewal, Inc. (Bronx, NY)
- …psychiatric services are provided Monday through Friday, staffed by a psychiatrist, nurse practitioner, registered nurse , and a licensed practical ... Housing Specialist Shelter- Ana's Place, 4380 Bronx Blvd, Bronx,...tracking system for submitted applications, interviews, and selections or denials . Performs follow-up to any denial of housing applications… more
- Hartford HealthCare (Farmington, CT)
- …Business Office in Newington. *_Position Summary:_* The Revenue Integrity Specialist determines the appropriateness of patient charges, and Charge Description ... and completeness, following regulatory requirements, in order to resolve edits, denials or exceptions detected during system processing of the claim. *_Position… more
- Munson Healthcare (Traverse City, MI)
- …required to obtain a BSN within 5 years of start date. + Current licensure as Registered Nurse in the State of Michigan. + Minimum of three years clinical ... Updates all involved parties regarding potential, threatened or actual denials due to lack of medical necessity or barriers...external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic work environment… more
- WMCHealth (Goshen, NY)
- Authorization Specialist Company: Bon Secours Charity Medical Group City/State: Goshen, NY Category: Clerical/Administrative Support Department: Goshen Medical Assoc ... Applicant link Internal Applicant link Job Details: Summary: The Authorization Specialist is responsible for performing complex clerical procedures related to… more