• Appeal Specialist RN

    Rush University Medical Center (Chicago, IL)
    …origin, disability, veteran status, and other legally protected characteristics. **Position** Appeal Specialist RN **Location** US:IL:Chicago **Req ID** ... more
    Rush University Medical Center (02/13/25)
    - Save Job - Related Jobs - Block Source
  • Denials Management Specialist , Full Time,…

    St. Luke's University Health Network (Allentown, PA)
    …near vision, visual monotony. EDUCATION: Graduate of an accredited professional nursing program. Registered nurse with current license to practice in the state ... more
    St. Luke's University Health Network (12/28/24)
    - Save Job - Related Jobs - Block Source
  • RN Utilization Review…

    HonorHealth (Scottsdale, AZ)
    …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... more
    HonorHealth (02/20/25)
    - Save Job - Related Jobs - Block Source
  • Denials Management RN Specialist

    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 ... more
    AdventHealth (01/27/25)
    - Save Job - Related Jobs - Block Source
  • RN Recovery Nurse Specialist

    Ochsner Health (New Orleans, LA)
    …in Appeal /Denial Management **Certifications** Required - Current State of Louisiana Registered Nurse ( RN ) License Preferred - Certification in Case ... more
    Ochsner Health (01/29/25)
    - Save Job - Related Jobs - Block Source
  • Specialist -Denial II RN - HS Denial…

    Baptist Memorial (Memphis, TN)
    …prior to initial appeal action in order to optimize reimbursement and utilization of resources. + Prepares response to appeal /request for information based ... more
    Baptist Memorial (01/23/25)
    - Save Job - Related Jobs - Block Source
  • Appeals and Grievances Clinical Specialist

    Healthfirst (IA)
    …Termination, and Suspension of services. The end to end process requires the Specialist to independently: + Research issues + Reference and understand HFs internal ... more
    Healthfirst (02/22/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Manager

    Ascension Health (Baltimore, MD)
    …process. + Serve as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. + ... more
    Ascension Health (12/17/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Documentation and Denial…

    CaroMont Health (Gastonia, NC)
    …conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. Where warranted, the Appeals Specialist will write ... more
    CaroMont Health (02/21/25)
    - Save Job - Related Jobs - Block Source
  • Population Health Nurse ( RN

    Ascension Health (Baltimore, MD)
    …and salary range at the time of the offer._ **Responsibilities** Manage assigned Registered Nurse ( RN ) case managers, related activities and workflow ... more
    Ascension Health (02/04/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Appeals Nurse ( RN ): Texas…

    Molina Healthcare (Columbus, OH)
    …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied ... more
    Molina Healthcare (02/09/25)
    - Save Job - Related Jobs - Block Source
  • Organizational Quality Nurse

    Hospice of Michigan (Kalamazoo, MI)
    …CARE Model of Service: courtesy, acknowledgement, response and empathy. Qualifications: + Registered Nurse with a baccalaureate degree in nursing, preferably a ... more
    Hospice of Michigan (02/20/25)
    - Save Job - Related Jobs - Block Source
  • Specialist , Grievance and Appeals

    VNS Health (Manhattan, NY)
    …to State Fair Hearings. Attends Fair Hearings in person with the Grievance and Appeals' RN Specialist and presents arguments in defense of the appeals. + Works ... more
    VNS Health (01/23/25)
    - Save Job - Related Jobs - Block Source
  • Sr. Revenue Integrity Analyst- On-site position

    WMCHealth (Valhalla, NY)
    …ensuring all denials are captured & appealed in a timely manner. Coordinating appeal discussions with clinical & third party payors. + Develop, Implement and ... more
    WMCHealth (12/13/24)
    - Save Job - Related Jobs - Block Source