- St. Luke's University Health Network (Allentown, PA)
- …communities we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party ... 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
- 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 ... cause and bring about the best opportunity for fair reimbursement. The Clinical Denial Management Specialist will adhere to the AHS Compliance Plan and to all… 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
- 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
- City and County of San Francisco (San Francisco, CA)
- …At least one (1) year of experience working as a Registered Nurse SPECIALTY REQUIREMENTS: + Clinical Documentation Specialist (CCDS) certification + At least ... LICENSE: Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License (**IMPORTANT: Be sure to include your… more
- Rush University Medical Center (Chicago, IL)
- …with Rush policies and procedures. **Other information:** **Required Job Qualifications:** * Licensed, registered nurse in the State of IL with at least 5 ... an overturned denial or has escalated through the proper channels. 4. Assist Utilization Management and Denials Management on implementing a strong process… 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
- Trinity Health (Maywood, IL)
- …and communication skills are necessary. + CPR (Cardiopulmonary Resuscitation) + Current Registered Nurse License State of Illinois + Specialty certification in ... hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist ** nurse works with the multidisciplinary team including physicians,… 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
- 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
- Tufts Medicine (Burlington, MA)
- …**Job Description** **Minimum Qualifications:** 1. Bachelor's Degree in Nursing 2. Active Registered Nurse ( RN ) license in Massachusetts or compact ... setting (ICU, ED, Critical Care, strong Med/Surg Specialty) or equivalent case management , utilization review, denials management , or progressive leadership… 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,...illness and/or substance abuse. Our comprehensive services include case management , individual and group counseling, recreational activities and housing… 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 ... level of care. + Updates all involved parties regarding potential, threatened or actual denials due to lack of medical necessity or barriers to the progression of… more
- Hartford HealthCare (Farmington, CT)
- …now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. ... Business Office in Newington. *_Position Summary:_* The Revenue Integrity Specialist determines the appropriateness of patient charges, and Charge Description… more
- Independent Health (Buffalo, NY)
- …Registered Health Information Technician (RHIT), Certified Clinical Documentation Specialist (CCDS), American Health Information Management Association ... the following certifications or licensures: Certified Inpatient Coder (CIC), Registered Health Information Management Administrator (RHIA), ...(CCS-H, CCS-P), Certification Denials and Appeals Management (C-DAM), or NYS licensed RN or… more
- University of Texas Rio Grande Valley (Harlingen, TX)
- … Specialist - P ( CCS - P) from the American Health Information Management Association ( AHIMA ), Registered Health Information Technician ( RHIT ) from ... Position Information Posting NumberSRGV7961 Working TitleCLINICAL DOCUMENTATION SPECIALIST Number of Vacancies1 LocationHarlingen, Texas DepartmentSchool of...the American Health Information Management Association ( AHIMA ), Registered Health… more
- Community Health Systems (Birmingham, AL)
- Utilization management is the analysis of the necessity, appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization ... that documentation supports the care with minimal risk of denials . To provide leadership and oversight of the UR...Coordinates insurance specific duties including CURP protocol. LPN or RN degree is required. Three years of previous nursing… more
- Fairview Health Services (St. Paul, MN)
- …of utilization management and quality improvement. License/Certification/Registration Current Registered Nurse license in the state of Minnesota. ... **Overview** M Health Fairview has an immediate opening for a Utilization Management Supervisor. This is a 1.0 FTE (80 hours per two week pay period),… more
- BayCare Health System (Clearwater, FL)
- …Call:** No **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management ) + Preferred CCM (Case Manager) ... or + Required 2 years in Case Management or + Required 3 years Registered Nurse + Preferred experience in Critical Care or Emergency Service **Benefits:** +… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …20 years of experience as an intensive care unit, emergency department or documentation specialist nurse auditor or an LPN with a combined coding and auditing ... Summary With direction from the Patient Financial Services Director, the Nurse Auditor/ Revenue Integrity/ CDM Analyst is responsible for performing audits of… more