- Fort Duncan Regional Medical Center (Eagle Pass, TX)
- …Manage department budget, staffing, and training needs. Function as Utilization Review/ Denials Manager as required. Qualifications Registered Nurse (RN) with ... a Texas license; relevant certification (CCM, ACM, CCM-RN) preferred. Proven leadership experience in acute care, utilization review, case management. Strong working knowledge of hospital billing, managed care systems, and discharge planning. Excellent skills… more
- Axsome Therapeutics (New York, NY)
- …City. About This Role Axsome Therapeutics is seeking a Field Reimbursement Manager (FRM) to collaborate with internal and external stakeholders to eliminate access ... and reimbursement challenges for Axsome's migraine product. The Field Reimbursement Manager will have responsibilities at a territory level and exhibit business… more
- Software Placement Group (White Plains, NY)
- Registered Nurse Care Manager The role of the RN Care Manager is integral to our patient care strategy. This position involves performing initial comprehensive ... and effective discharge planning to prevent readmissions. The RN Care Manager ensure coordination of care through intra-hospital and inter-hospital levels,… more
- Neolytix LLC (Chicago, IL)
- Job Title: Medical Billing Manager | Customer Success - Chicago Location: Loop, Chicago, IL About Neolytix: Neolytix is a leading provider of healthcare management ... services. Job Summary: We are looking for a proactive and client-focused Customer Success Manager to join our team. In this role, you will be responsible for… more
- AdventHealth (Altamonte Springs, FL)
- …and world-class resource The role you'll contribute : The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians and the ... and progression through the continuum of care. The RN Care Manager ensures efficient and cost-effective care through appropriate resources monitoring, and… more
- Iconma LLC (Charlotte, NC)
- Our Client, a Medical/Healthcare company, is looking for a Manager - Chargemaster for their Charlotte, NC/Hybrid location. Responsibilities: Maintains a work ... office, CBOE, etcetera to address operational issues that are contributing to denials . Cox deliberately and systematically under pressure and projects confidence and… more
- Cedars Sinai (Los Angeles, CA)
- …What you will be doing in this role: The Revenue Cycle Client Services Manager oversees and manages client relationships with Physician Billing Services (PBS) in all ... monthly trends for the key performance indicators of aging days, charges, revenue, denials trend and quality reviews. Includes analysis of these trends and action… more
- Mount Sinai Hospital (New York, NY)
- Job Description Patient Accounts Manager (Billing Project Management) Patient Financial Services- Corporate- Full-Time Days The Patient Accounts Manager oversees ... Monitors the referral of self-pay accounts to collection agency. Reviews all denials for proper procedures and corrective measures. Monitors and adheres to all… more
- Boston Childrens Hospital (Boston, MA)
- …level of care for admissions and with post-discharge appeals of payer denials . They identify and implement initiatives to manage utilization trends, collaborating ... experience required, pediatric experience preferred. Experience as a Case Manager (Discharge Planning and or Utilization Management) preferred. Licensure/… more
- AdventHealth (Hinsdale, IL)
- …Street, Hinsdale, IL The role you'll contribute: The Social Work Care Manager intervenes with patients who have complex psychosocial needs, require assistance with ... nurses, and other members of the care team). The Social Work Care Manager , in collaboration with the patient/family, care manager nurses, nurses, physicians… more
- Valley Presbyterian (Los Angeles, CA)
- Job Summary: As a Registered Nurse/Case Manager , Case Management Unit, you will play a pivotal in a variety of tasks that lead to a high level of customer ... call-in and approval dates are entered in the Meditech System to avoid payor denials . Respond to MCO or medical groups within 24 hours of receiving notice when… more
- The LaSalle Group (Evanston, IL)
- …team. Thisrole will have a strong focus on resolving complex clinical denials through evidence-based appeals. The Clinical Appeals Specialist will play a critical ... per day for medical necessity, level of care, and authorization-related denials . Draft well-supported, clinically sound appeal letters using medical documentation… more
- Northwestern Memorial Healthcare (Chicago, IL)
- …of third party payer receivables and tracking of third party yields. Denials and Appeals management including root cause analysis to reduce/prevent future ... denials while working to overturn denials for...any suspected breaches or concerns to the Patient Accounting Manager and Corporate Integrity & Compliance (HIPAA, Patient Privacy,… more
- NYC Health Hospitals (New York, NY)
- …Reporting to the Director of Patient Accounts, the Patient Accounts Manager works independently and collaboratively to oversee resident billing, insurance claims, ... and financial counseling for residents and families. The Patient Accounts Manager is also responsible for ensuring regulatory compliance, improving collections, and… more
- Mount Sinai Hospital (Elmhurst, NY)
- …timely and complaint manner. Work with the Faculty Practice Group Compliance Manager and Administrator to ensue all FPG revenue is captured. Responsibilities ... and/or meet with physicians regarding documentation and deficiencies. Review edits, denials and requests for additional information from the accounts receivable team… more
- Baystate Health (Springfield, MA)
- The RN Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality, and financial outcomes of a designated population of ... patients. The Hospital Case Manager is responsible for overseeing an efficient plan that...interventions for patients at risk for readmissions Manages concurrent denials and works with physicians to overturn for appropriate… more
- Generis Tek, Inc. (Gainesville, FL)
- …at email address ###@generistek.com can be reached on # ###. We have Permanent role Case Manager RN for our client at Gainesville, FL. Please let me know if you or ... of your friends would be interested in this position. Position Details: Case Manager RN- Gainesville, FL Location : 6500 Newberry Road, PO Box 147006, Gainesville,… more
- Lighthouse Autism Center (Mishawaka, IN)
- …Job Summary The Insurance Coordinator reports to the Insurance and Billing Manager and helps our ABA learner families navigate the complexities of eligibility, ... plans File and assist team members with appeals on authorization denials through third-party billing organization Handle learner pre-authorizations and documentation… more
- BLACKBURN'S PHYSICIANS PHARMACY (Tarentum, PA)
- …for both healthcare providers and the communities we serve. The Claims Manager leads the daily operations of the claims department, ensuring timely, accurate, ... the escalation point and subject matter expert for complex claims scenarios, denials , and payer policies. Ensure all Claims processed align with Medicare, Medicaid,… more
- Sharp HealthCare (La Mesa, CA)
- …Nursing -REQUIRED Preferred Qualifications Bachelor's Degree in Nursing Certified Case Manager (CCM) - Commission for Case Manager Certification -PREFERRED ... organization goals including reductions in length of stay, decreasing denials , improvement of care transitions, and reduction in avoidable...next level of care; work closely with ambulatory care manager (ACM) at the system level, in clinics, with… more
