- St. Mary's Healthcare (Amsterdam, NY)
- …of nursing required. Licensure / Certification / Registration: Required Credential(s): * Registered Nurse credentialed from the New York Board of Nursing. ... recognize and resolve billing inconsistencies. * Reviews commercial and government claim denials and audit requests and coordinates attempts to overturn denials … more
- AdventHealth (Winter Garden, FL)
- …patients who no longer meet medical necessity and escalates potential denials , documents avoidable days, and facilitates progression of care. + Collaborates ... primary care physician identification and scheduling of follow-up PCP and specialist appointments for post-hospital follow up care. + Ensures discharge disposition… more
- BayCare Health System (Cotton Plant, AR)
- …Critical Care or Emergency Nursing RN. **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management) + Preferred CCM ... **BayCare Health System** is currently seeking a **Utilization Review Specialist Senior** to join our outstanding and compassionate team....2 years in Case Management + Preferred 3 years Registered Nurse in Critical Care or Emergency… more
- Sanford Health (Thief River Falls, MN)
- …**Qualifications** Graduate from an accredited practical nursing program as a Licensed Practical Nurse (LPN). Registered Nurse (RN) preferred. Five years' ... **Department Details** Come join our Behavioral Health team as a Utilization Review Specialist utilizing a team-based approach to patient care in a fun and… more
- Access Dubuque (Dubuque, IA)
- …Scholarship Medical Associates RN - FT Nights Weekend Package - MercyOne Dyersvil MercyOne Registered Nurse - Pediatrics - FT Nights MercyOne Registered ... Clerical/Billing Support Specialist | Lab | FT **MercyOne** 1 Positions...Nurse - Float Pool - FT Nights MercyOne Registered Nurse - Float Pool - FT… more
- Granville Health System (Oxford, NC)
- …Required:#Graduate from a Board approved nursing program with current licensure as a registered nurse in the state of North Carolina required; #Familiarity with ... Summary:#The CDI Specialist is responsible for improving the overall quality...of Present on Admission indicators. #Obtains documentation relevant to denials avoidance related to the Recovery Audit program, the… more
- Indian Health Service (Gallup, NM)
- …Clinical Director to resolve complex medical documentation problems. Utilizes Registered Nurse Training and expertise to prevent denials by instructing and ... Center in Gallup, NM. The purpose is to serve as the Nurse (Utilization Review) responsible for planning, organizing, implementing, & evaluating the functions… 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 state 3. ... **Job Profile Summary** The role of the Clinical Documentation Integrity (CDI) Specialist III is responsible for concurrent and retrospect review and analysis of the… 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,...tracking system for submitted applications, interviews, and selections or denials . Performs follow-up to any denial of housing applications… more
- Carle (Urbana, IL)
- …Carle at The Fields + Weekend Requirements: no + Other Posting Information: Registered Professional Nurse (RN) License Illinois upon hire. + Holiday ... Outpatient Denial/Appeals Specialist - RN + Department: Revenue Cycle - CFH_10_19...REQUIREMENTS Bachelor's Degree in Nursing CERTIFICATION & LICENSURE REQUIREMENTS Registered Professional Nurse (RN) License Illinois upon… more
- HonorHealth (Scottsdale, AZ)
- …Degree in Nursing from an accredited NLN/CCNE institution Required Experience 3 years Registered Nurse in an acute care setting. Required 1 year experience ... in UR/UM or Case Management Required Licenses and Certifications Registered Nurse (RN) State And/Or Compact State Licensure Required more
- Select Medical (West Orange, NJ)
- …14. Performs other duties as requested. **Qualifications** **Minimum Qualifications** + Licensure as a Registered Nurse or LVN/LPN is required + 2 years of of ... **Overview** **Kessler Institute for Rehabilitation** West Orange, NJ **Prior Authorization Specialist /Payor Relations Specialist - This is an** **onsite**… more
- Select Medical (Frisco, TX)
- …14. Performs other duties as requested. **Qualifications** **Minimum Qualifications** + Licensure as a Registered Nurse or LVN/LPN is required + 2 years of of ... with Select Medical & Baylor Scott & White Health **Prior Authorization Specialist -** **onsite only** **This position must work** **onsite** **at** **Baylor Scott… more
- Carle (Urbana, IL)
- …required within five (5) years of start date CERTIFICATION & LICENSURE REQUIREMENTS Registered Professional Nurse (RN) License Illinois upon hire and Accredited ... Clinical Transition Specialist RN - Weekend Program + Department: IP...swing bed patients, maintain the work ques, and address denials . + RMH: make follow up appointments with primary… more
- University of Utah Health (Salt Lake City, UT)
- …Review or Case Management experience. **Licenses Required** + Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 ... and frequent utilizers. + Collaborate with unit case manager, utilization review nurse and other organization staff on establishing an appropriate plan to support… more
- Fairview Health Services (St. Paul, MN)
- …(RHIT), Registered Health Information Administrator (RHIA), Registered Nurse (RN), Certified Documentation Integrity Specialist (CCDS), or Certified ... resource and helps to validate post claim DRG downgrade denials related to coding and clinical determination to support...AND + One of the following: Registered Nurse (RN), Certified Documentation Integrity Specialist (CCDS),… more
- AdventHealth (La Grange, IL)
- …AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse (RN) . Two (2) years of medical/hospital nursing experience ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- UNC Health Care (Rocky Mount, NC)
- …Professional Experience Requirements: * 2 years' experience in healthcare/medical field as registered nurse * 5 years of experience in Healthcare/Medical - ... and reports losses incurred due to extended stay and admission denials . Differentiates and reports internal, external, patient/family origin for delayed discharges.… more
- Fairview Health Services (Minneapolis, MN)
- …years clinical experience, strong assessment, and evaluation skills Licensed as a Registered Nurse or Rehabilitation Professional in State of Minnesota ... clinical specialization and further recognition and compensation through our clinical specialist program. As an industry leader in rehabilitative care with… more