- St. Mary's Healthcare (Amsterdam, NY)
- …of nursing required. Licensure / Certification / Registration: Required Credential(s): * Registered Nurse credentialed from the New York Board of Nursing. ... recognize and resolve billing inconsistencies. * Reviews commercial and government claim denials and audit requests and coordinates attempts to overturn denials … more
- AdventHealth (Winter Garden, FL)
- …for the mind, body, and spirit! **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians, ... care coordination and progression through the continuum of care. The RN Care Manager ensures efficient and cost-effective care through appropriate resources… 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
- 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...from an accredited NLN/CCNE institution Required Experience 3 years Registered Nurse in an acute care setting.… more
- Carle (Urbana, IL)
- …Location: Carle at The Fields + Weekend Requirements: no + Other Posting Information: Registered Professional Nurse ( RN ) License Illinois upon hire. + ... Outpatient Denial/Appeals Specialist - RN + Department: Revenue Cycle...REQUIREMENTS Bachelor's Degree in Nursing CERTIFICATION & LICENSURE REQUIREMENTS Registered Professional Nurse ( RN ) License… more
- Carle (Urbana, IL)
- …Nursing required within five (5) years of start date CERTIFICATION & LICENSURE REQUIREMENTS Registered Professional Nurse ( RN ) License Illinois upon hire and ... Clinical Transition Specialist RN - Weekend Program +...swing bed patients, maintain the work ques, and address denials . + RMH: make follow up appointments with primary… 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
- Access Dubuque (Dubuque, IA)
- Clerical/Billing Support Specialist | Lab | FT **MercyOne** 1 Positions...RN - FT Days - MercyOne Dyersville MercyOne Registered Nurse - Rehab - FT - ... AM - 6:00 PM) **POSITION PURPOSE:** The Clerical/Billing Support Specialist is responsible for performing excellent customer service to...- FT Nights Weekend Package - MercyOne Dyersvil MercyOne Registered Nurse - Pediatrics - FT Nights… more
- BayCare Health System (Cotton Plant, AR)
- …Critical Care or Emergency Nursing RN . **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management) + Preferred ... **BayCare Health System** is currently seeking a **Utilization Review Specialist Senior** to join our outstanding and compassionate team....2 years in Case Management + Preferred 3 years Registered Nurse in Critical Care or Emergency… 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 East Tennessee's ... named six times by Forbes as a Best Employer. Position Summary:The CDI Specialist serves as liaison between the physicians and hospital departments to promote… 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 ... **Job Profile Summary** The role of the Clinical Documentation Integrity (CDI) Specialist III is responsible for concurrent and retrospect review and analysis of the… more
- Sanford Health (Thief River Falls, MN)
- …from an accredited practical nursing program as a Licensed Practical Nurse (LPN). Registered Nurse ( RN ) preferred. Five years' experience in a clinical ... **Department Details** Come join our Behavioral Health team as a Utilization Review Specialist utilizing a team-based approach to patient care in a fun and… more
- Granville Health System (Oxford, NC)
- …Required:#Graduate from a Board approved nursing program with current licensure as a registered nurse in the state of North Carolina required; #Familiarity with ... 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
- Select Medical (West Orange, NJ)
- …14. Performs other duties as requested. **Qualifications** **Minimum Qualifications** + Licensure as a Registered Nurse or LVN/LPN is required + 2 years of of ... **Overview** **Kessler Institute for Rehabilitation** West Orange, NJ **Prior Authorization Specialist /Payor Relations Specialist - This is an** **onsite**… more
- Select Medical (Frisco, TX)
- …14. Performs other duties as requested. **Qualifications** **Minimum Qualifications** + Licensure as a Registered Nurse or LVN/LPN is required + 2 years of of ... with Select Medical & Baylor Scott & White Health **Prior Authorization Specialist -** **onsite only** **This position must work** **onsite** **at** **Baylor Scott… 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
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview The Clinical Coding and Audit Specialist monitors, responds and performs the clinical coding and audit support ... appeals, root cause analysis, and address identified trends in reasons for denials related to coding and/or OASIS related documentation. Partners with Home Health… more
- University of Utah Health (Salt Lake City, UT)
- …Review or Case Management experience. **Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 ... and frequent utilizers. + Collaborate with unit case manager, utilization review nurse and other organization staff on establishing an appropriate plan to support… more
- Hackensack Meridian Health (Hackensack, NJ)
- …serve as a leader of positive change. The Integrated Case Management Specialist performs selected services and functions related to insurance management with various ... day in the life of an Integrated Case Management Specialist at Hackensack Meridian _Health_ includes: + In collaboration...+ Enters LAD into EPIC. + Keeps Utilization Review RN current on updates needed for payors. + Enters… more
- Baptist Memorial (Memphis, TN)
- Summary Authorization Denial Specialist ensures that chemotherapy (specialty group) and other infusions/radiation therapy/radiology/ surgical services meet medical ... and supporting documentation for outpatient or Part B services authorization denials to determine and perform retro authorizations, reconsiderations or appeal… more