- PeaceHealth (Vancouver, WA)
- **Description** PeaceHealth is seeking a RN Clin Doc Integrity Specialist/ Denial Reviewer for a Full Time, 1.00 FTE, Day position. The salary range for this ... to payers. Provides support in development of the clinical denial process, letter templates, and process improvements. Ideal candidate...in the inpatient acute care setting Credentials + Required: Registered Nurse In state of practice or… more
- Carle (Urbana, IL)
- …Work Location: Working from Home + Weekend Requirements: no + Other Posting Information: Registered Professional Nurse ( RN ) License Illinois upon hire. + ... Outpatient Denial /Appeals Specialist- RN + Department: Revenue...REQUIREMENTS Bachelor's Degree in Nursing CERTIFICATION & LICENSURE REQUIREMENTS Registered Professional Nurse ( RN ) License… more
- AdventHealth (Altamonte Springs, FL)
- …role you'll contribute:** The Divisional Manager of Utilization Management (UM) is a registered nurse , who works under the direction of the Divisional Director ... focuses on ensuring efficient productivity, compliant workflows, and clinically appropriate denial prevention across the region that aligns with the AdventHealth… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …appeals and acquire authorizations for treatment Key Qualifications: + Current NYS Registered Nurse License/Registration and BSN preferred + At least 2-3 ... our mission at MSK and around the globe. Please review important announcements about vaccination requirements and our upcoming...link is only accessible for MSK employees. Job Description RN Case Manager, Inpatient | New York, NY Exciting… more
- Highmark Health (Harrisburg, PA)
- …planning and community resource knowledge + Care facilitation and utilization review experience **LICENSES or CERTIFICATIONS** **Required** + RN license ... **Company :** Endorsed **Job Description :** **JOB SUMMARY** ** Remote /Hybrid - In home visits in and around...outcomes. Interviews and collects patient specified data and chart review related to readmission. + Knowledgeable of and complies… more
- LifePoint Health (Brentwood, TN)
- …reliable attendance. . Perform other duties as assigned. *What you'll need:* *Education: * Nurse ( RN , NP, or graduate of a state approved nursing ... implementation and management of processes related to the concurrent review of the clinical documentation in the inpatient medical...taken within appeal time frames to address DRG downgrade denial . . Serve as subject matter expert on … more
- Fairview Health Services (St. Paul, MN)
- …Information Technician (RHIT), Registered Health Information Administrator (RHIA), Registered Nurse ( RN ), Certified Documentation Integrity Specialist ... Health Information Administrator (RHIA). AND + One of the following: Registered Nurse ( RN ), Certified Documentation Integrity Specialist (CCDS),… more
- R1 RCM (Detroit, MI)
- …experience working as a Clinical Appeals Nurse :** + Conduct a detailed review of patient medical records and payer denial information submitted by clients ... appeals.Represent clients at telephonic hearings if needed. **Required Skills:** + Active Registered Nurse license For this US-based position, the base pay… more
- Sanford Health (SD)
- …be required. OR Currently holds an unencumbered Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) license with State Nursing board and /or possess ... of health and healing across our broad footprint.** **Facility:** Remote SD (Central Time) **Location:** City - Remote...role. Understands and support the Medicare workflows related to denial review and appeals management, including the… more
- R1 RCM (Chicago, IL)
- …ensure internal and external compliance deadlines are met. **Required Skills:** + Active Registered Nurse license + **Active AHIMA or AAPC Coding Certification** ... analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical records… more
- Hackensack Meridian Health (Neptune, NJ)
- …and utilization management **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health Care Life Support ... and follows the state of New Jersey regulations for Nursing **.** **This is a remote , night shift position. The schedule for this role is 11:00 pm - 7:30 am.**… more
- R1 RCM (Boise, ID)
- …identify targeted areas for additional support and engagement. **Required Skills:** + Active Registered Nurse license . For this US-based position, the base pay ... you will help support clinicians who conduct a comprehensive review of clinical denials and formulate appeals based on...quality metrics are met and regularly identify and communicate denial trends and patterns to leadership. To thrive in… more