- Catholic Health Initiatives (Omaha, NE)
- …role within the revenue cycle by providing clinical expertise in the denials management process. The Denials RN performs a root cause analysis of ... as assigned by the manager. **Qualifications** **Required:** + Minimumthree (3)yearsclinical experience as Registered Nurse ( RN ) required. + RN license… more
- University of Michigan (Ann Arbor, MI)
- …independently. + Knowledge of healthcare regulations and compliance requirements + Experience in denials management and appeals is a plus **Work Schedule** This ... Coding and Appeals Coordinator plays a vital role in the revenue cycle management of Rev Cycle Mid-Service by maintaining the financial integrity of the healthcare… more
- Alameda Health System (Oakland, CA)
- …completion of financial analyses including cost of care to reimbursement, denials management , and non-reimbursed services, promoting effective resource ... Director, Inpatient System Care Management + Oakland, CA + Highland General Hospital...Preferred Experience: N/A Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California… more
- UNC Health Care (Chapel Hill, NC)
- …Management . This role is responsible for the daily operations of the Utilization Management and Clinical Denials Management functions of the department as ... unique communities we serve. Looking for a dynamic, seasoned ** RN with at least seven (7) years of Utilization/Case... with at least seven (7) years of Utilization/Case Management experience and at least two (2) years of… 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 ... setting (ICU, ED, Critical Care, strong Med/Surg Specialty) or equivalent case management , utilization review, denials management , or progressive leadership… more
- R1 RCM (Salt Lake City, UT)
- …will help our hospital clients by serving as an expert on appeals and denials management where claims were denied by either governmental contractors or ... patient care as well as conceptual knowledge of the denials landscape. Proficiency in basic computer skills is essential...at telephonic hearings if needed. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
- Houston Methodist (Baytown, TX)
- …HM performance that demonstrates leadership responsibility **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or ... of opportunities for appropriate utilization of resources to avoid denials and resource management as it pertains...Compact State Licensure within 90 days or + RN -Temp - Registered Nurse -… more
- AdventHealth (Hinsdale, IL)
- …resolution skills . Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** . State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- AdventHealth (Hinsdale, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- AdventHealth (Ocala, FL)
- …need to succeed** **:** **REQUIRED:** EDUCATION AND EXPERIENCE REQUIRED: * Associates Degree Nursing or RN Diploma degree * Registered Nurse ( RN ) * Two ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- Geisinger (Bloomsburg, PA)
- …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... of care using predetermined criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through… more
- HCA Healthcare (Largo, FL)
- …environment where diversity and inclusion thrive? Submit your application for our Prebill Denials Analyst opening with Parallon today and find out what it truly ... **_Note: Eligibility for benefits may vary by location._** We are seeking a Prebill Denials Analyst for our team to ensure that we continue to provide all patients… more
- AdventHealth (Altamonte Springs, FL)
- …CERTIFICATION OR REGISTRATION REQUIRED:** * Basic Life Support - CPR Cert * Registered Nurse This facility is an equal opportunity employer and complies ... Ethics, the ANA Scope and Standard for Nursing Practice, and the AONE Nurse Executive Competencies. *Liaises between Care Management , Nursing, and Hospital… more
- Bon Secours Mercy Health (Greenville, SC)
- …Experienced RNs **Summary of Primary Function/General Purpose of Position** The RN Outpatient Wound Care performs and documents complete patient assessments, ... including scheduling, registration, clinical coverage/treatment, documentation, billing, collections, and denials . * Assists leadership to perform auditing to ensure… more
- Tenet Healthcare (Detroit, MI)
- …Nursing, Business Administration or Hospital Administration preferred. 2. Licensed to practice as a Registered Nurse in the State of Michigan; 3. Three to five ... “peer to peer” review process with payers to resolve denials or downgrades concurrently. Transition Management ·...Hospital Administration preferred. 2. Licensed to practice as a Registered Nurse in the State of Michigan;… more
- Sharp HealthCare (San Diego, CA)
- …Certification; Accredited Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse ( RN ) - CA Board of Registered ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...documented in the electronic medical record (EMR), and case management software.The RN CM I will develop… more
- Actalent (Riverside, CA)
- …of recent (in the last 1-3 years) Case Management experience for Riverside. Registered Nurse - RN Experience Level: Entry Level About Actalent Actalent ... complies with the scope of services defined by the Registered Nurse RN state licensure...Order clarification admission status and patient classification. Skills: case management , acute care, Registered Nurse ,… more
- Billings Clinic (Billings, MT)
- …loan reimbursement Under the direction of department leadership, the Utilization Review/ Management RN . This position is to conduct initial, concurrent, ... Licenses * Healthcare Provider CPR Certification At hire * Current Montana license as a Registered Nurse At hire * Current working knowledge of payer and managed… more
- AdventHealth (Daytona Beach, FL)
- …32117 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... **The value you'll bring to the team:** The Utilization Management Nurse is accountable for a designated...qualifications** : o Associate and 3 years experience o Registered Nurse o Current and valid license… more
- Hartford HealthCare (Southington, CT)
- …concisely. **Maintains a flexible schedule to meet the needs of the agency. Licensure: Registered Nurse with a license to practice in the State ofConnecticut ... be spent in the following activities: **Monitor Advanced Beneficiary Notices and denials as it relates to medical necessity requirements. **Identify and evaluate … more