- UNC Health Care (Kinston, NC)
- …to support the clinical documentation specialists and Patient Financial Services. Supports the Utilization Review Nurse team when necessary by applying ... the team in the strategy to appeal all clinical denials . Provides the clinical expertise to draft the first...a Registered Nurse required. + 2 years utilization review , care management, or compliance experience… more
- Datavant (Raleigh, NC)
- …healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical ... be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials ...letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers +… more