- 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 ...an accredited, professional nursing program. + Must have current RN license to practice in the state of Pennsylvania… 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
- 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
- PeaceHealth (Vancouver, WA)
- …DRG-downgrade denials in the inpatient acute care setting Credentials + Required: Registered Nurse In state of practice or + Required: Certified Clinical ... change agent with in-depth knowledge of workflow related to denials and appeals management . Performs in depth...adult medicine. (Required) Department / Location Specific Notes Additional Registered Nurse licensure may be required within… more
- BayCare Health System (St. Petersburg, 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
- Covenant Health Inc. (Knoxville, TN)
- Overview Clinical Documentation Integrity Specialist Part Time, 48 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's ... to be named a Forbes "Best Employer" seven times. Position Summary: The CDI Specialist serves as a liaison between the physicians and hospital departments to promote… more
- CaroMont Health (Gastonia, NC)
- …with Health Information Management , Utilization Review and Clinical Documentation Specialist to mitigate coding denials . This position is for CaroMont ... Job Summary: The Clinical Documentation and Denial Specialist will assist with development and execution of... is responsible for assisting the denial coordinator with management of client DRG denials by conducting… more
- Sanford Health (Sioux Falls, SD)
- …for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to assure compliance… more
- Sanford Health (SD)
- …from an accredited practical nursing program as a Licensed Practical Nurse (LPN). Registered Nurse ( RN ) preferred. Five years' experience in a clinical ... Summary** Provides clinical support to the MCHS revenue cycle for denial management and clinical workflows within the patient financial service department. Will be… 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
- 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
- Community Health Systems (Franklin, TN)
- **Job Summary** The Appeals Specialist II, under the direction of the Director of Denial Support Services, logs and reviews per documentation guidelines for report ... of data and information. This position provides feedback to facilities regarding denials that are resulting in retractions. **Essential Functions** + Responsible for… 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
- MD Anderson Cancer Center (Houston, TX)
- …degree in nursing (ADN). Experience Required: Three years of experience as a Registered Nurse . Licensure Required: Current State of Texas Professional Nursing ... the public. The primary purpose of the Utilization Review Nurse position is to: Evaluate the necessity, appropriateness, and...facilitate timely peer to peer or appeals to mitigate denials KEY FUNCTIONS Standards of Practice a₠" Utilization Review… 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
- AdventHealth (Bolingbrook, IL)
- …for individuals from at-risk populations from interdisciplinary team members (including physicians, RN Care Managers, staff nurses, and other members of the care ... Clinical Social Worker is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of post-hospital… more