- R1 RCM (Chicago, IL)
- …one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, ... meetings on a routine basis. **Required Skills:** + Active Registered Nurse license + Active AHIMA or...combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most… more
- Rush University Medical Center (Chicago, IL)
- …trends and work collaboratively with clinical providers, coders, insurance companies and revenue cycle leadership to prevent future clinical denials by ... with Rush policies and procedures. **Other information:** **Required Job Qualifications:** * Licensed, registered nurse in the State of IL with at least 5… more
- Corewell Health (Trenton, MI)
- …medical necessity screening criteria, when appropriate. Works collaboratively with departmental, revenue cycle , and clinical appeals staff, physicians, ... in care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required How… more
- Corewell Health (Royal Oak, MI)
- …medical necessity screening criteria, when appropriate. Works collaboratively with departmental, revenue cycle , and clinical appeals staff, physicians, ... in care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon Hire required… more
- Baptist Memorial (Memphis, TN)
- Summary Medicare / Medicaid Appeals Registered Nurse reviews and evaluates medical documentation to support billing compliance and external regulatory ... payment methodologies Training Minimum: Successful demonstration and detailed understanding of Hospital Revenue Cycle , CPT codes, HCPC codes, modifiers, and the… more
- AdventHealth (Altamonte Springs, FL)
- …2 years utilizing InterQual and/or MCG . Minimum of three (3) years' experience as Registered Nurse ( RN ) in an acute clinical setting . Clinical experience ... English language is crucial for basic job functioning. Understanding revenue cycle processes is necessary in order...obtain further patient information to be used in the appeals process if necessary. . Provide reports, education, and… more
- Sharp HealthCare (San Diego, CA)
- …Case Manager (CCM) - Commission for Case Manager Certification; Bachelor's Degree in Nursing; California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...secondary review and share findings with providers.Provide advice to Revenue Cycle /HIM regarding RAC decision to appeal,… more
- The Cigna Group (Bloomfield, CT)
- …and reimbursement for multiple Therapeutic Resource Centers. **QUALIFICATIONS** + Active, unencumbered Registered Nurse ( RN ) license in state of residency. ... Nurse Clinician - Accredo Job Description Summary The Nurse Clinician - RN is responsible for...is preferred in prior authorization or utilization review and appeals + Demonstrated proficiency with Microsoft Office software; basic… 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 ... operations and optimal resource allocation. Track and report on financial performance. * * Revenue Cycle Optimization:* Collaborate with revenue cycle … more
- Sharp HealthCare (San Diego, CA)
- …**Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse ( RN ) - CA Board of Registered ... case management, utilization review, care coordination experience. + California Registered Nurse ( RN ) - CA...secondary review and share findings with providers.Provide advice to Revenue Cycle /HIM regarding RAC decision to appeal,… more
- BrightSpring Health Services (Louisville, KY)
- …audit, RCD submission and result percentages back and up through operations and revenue cycle .* Analyzes information gathered by audits and reports finding and ... Clinical Denials Management and Audit supervises a team of RN /LPN clinical reviewers as well as Support staff managing...branches for all payor types striving to minimize lost revenue . Conducts analysis on denials and appeals … more
- State of Colorado (Pueblo, CO)
- …with BEHR, the electronic Health record, specifically Power Chart; Access HIM, and Revenue Cycle . + Is responsible for verifying what documents should be ... requirements. + Keep a record of due dates for RN annual assessments, and Social Work and Psychiatric biannual...the department's action. + For more information about the appeals process, the official appeal form, and how to… more