- Baptist Memorial Health Care Corporation (Memphis, TN)
- …more of the following: 3-5 years insurance provider, auditing, or medical review experience performing activities related to denied claims such as obtaining ... Overview Specialist-Denial Mitigation II RN Job Code : 21432 FLSA Status Job...Nursing, Case Management or Denial Management. Familiarity with electronic medical records and claims /practice management systems. Requires… more
- American Health Partners (Twin Falls, ID)
- …to change and be able to collaborate with multiple teams JOB SUMMARY: The Registered Nurse Case Manager is responsible for providing daily management and support ... Coordination program *Perform improvement projects involving development of monitoring/collection tools, review of medical records, data entry, analysis, and… more
- Jamie Grayem (Downey, CA)
- …standards for corrective action plan for improvement identified through utilization review , clinical records audit, claim denials, patient satisfaction surveys, ... changes to the reimbursement structure, and the impacts of changes in medical science to hospital performance, among others; maintaining a culture of continuous… more
- CAMC Health System (Charleston, WV)
- …provider(s) rendering services to the patient, as directed by the provider or Registered Nurse if applicable as outlined in departmental policies and procedures. ... by policy, and disposition of calls. Retrieve, photocopy, as necessary and file medical records; prepare, review and process records to endure completeness and… more
- Regal Medical Group, Inc. (San Bernardino, CA)
- …that improve program outcomes. Identifies and assists in the development of Concurrent Review policies and procedures and assists the Medical Director to oversee ... The Clinical Project Manager works directly with the Campus Medical Director towards the goal of enhancing the overall...and will assist in implementing care plans. They will review discharge plans for thoroughness and completion, working with… more
- State of Connecticut, Department of Administrative Services (New Haven, CT)
- … medical treatment facility, in rehabilitative or occupational nursing or providing medical review of insurance claims . MINIMUM QUALIFICATIONS - ... Utilization Review Nurse (40 Hour) Office/On-Site Recruitment...(https://www.jobapscloud.com/CT/jobs/?b=Benefits) + + + + Introduction Are you a Registered Nurse looking for an opportunity to… more
- Houston Methodist (Sugar Land, TX)
- …the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse ( RN ) who comprehensively conducts point of entry and ... concurrent medical record review for medical ...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse ( RN ) who comprehensively conducts point of entry and ... concurrent medical record review for medical ...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse - Payment Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 ... policies within the claim adjudication process through medical record review for Payment Integrity and...Office suite, including Word, Excel and PowerPoint. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- InGenesis (Columbia, SC)
- InGenesis is currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our client located in Columbia, SC. In this role you will ... any questions you may have. Job Duties * Perform medical review /authorization process. * Ensure coverage for...Perform other duties as assigned. Minimum Qualifications * Current Registered Nurse / RN license… more
- Ascension Health (Wichita, KS)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing ... **Details** + **Department:** Utilization Review + **Schedule:** Full time, 36 hrs, Day...+ Assist departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement and claim denials/appeals.… more
- AdventHealth (Altamonte Springs, FL)
- …Remote **The role you'll contribute:** A Workers Comp Support Registered Nurse is responsible for providing telephonic medical case management for Workers ... Independent Medical Examinations or submitting formal Utilization Review with clinical director and claims adjuster...is essential **LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED:** + Active Registered Nurse ( RN ) license in… more
- Emanate Health (Covina, CA)
- …States, and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical ... protocol sets, or clinical guidelines and provide support and review of medical claims and...customer service skills required. **Minimum License Requirement :** California RN license. Delivering world-class health care one patient at… more
- Commonwealth of Pennsylvania (PA)
- Registered Nurse Supervisor (2nd Shift) - Selinsgrove Center Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5002155) Apply Registered ... compassionate individual to grow their leadership skills as a Registered Nurse Supervisor. In this role, you...services. You can expect to participate in the development, review , training and implementation of center policies and procedures.… more
- The County of Los Angeles (Los Angeles, CA)
- …be active and unrestricted. Successful candidates are required to provide proof of their Registered Nurse ( RN ) License and Basic Life Support (BLS) ... REGISTERED NURSE I/RELIEF NURSE ...vaccination against COVID-19 or request an exemption for qualifying medical or religious reasons during the onboarding process. Candidates… more
- US Tech Solutions (Columbia, SC)
- …available resources to promote quality, cost effective outcomes. + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate ... **Duration: 3+ Months Contract (Possible Extension)** **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. +… more
- Staffing Solutions Organization (Augusta, ME)
- …diverse workforce, which is a reflection of our clients and the people they serve. ** Registered Nurse - Authorization Review Unit - MaineCare in Augusta, ... ME** **Position Duties:** + Manage medical Prior Authorizations (PA) as assigned by the PA...Ability to develop and implement corrective actions. **Minimum Qualification:** Registered Nurse and three (3) years of… more
- The County of Los Angeles (Los Angeles, CA)
- REGISTERED NURSE I, SHERIFF (CORRECTIONAL HEALTH) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2930992) Apply REGISTERED NURSE ... is currently offering up to 20% bonus for full-time Registered Nurse I, Sheriff positions hired by...vaccination against COVID-19 or request an exemption for qualifying medical or religious reasons during the onboarding process. Candidates… more
- The County of Los Angeles (Los Angeles, CA)
- …REQUIREMENTS: OPTION I:One year of experience performing the duties of a Utilization Review Nurse * or Medical Service Coordinator, CCS.** -OR- OPTION ... II: Two (2) years of experience as a registered nurse , of which one year must...may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN … more
- Ascension Health (Baltimore, MD)
- …management rules and regulations. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Maryland Board of Nursing ... cases. + Assist departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement and claim denials/appeals. +… more
