- Hartford HealthCare (Farmington, CT)
- …And this is *your moment.* **Job:** **Administrative* **Organization:** **Hartford HealthCare Corp.* **Title:** * Denial RN DRG Appeal Writer1 / HIM ... practices that support appropriate reimbursement. . Ensure that all DRG denial and appeal activities...management and appeals preferred. **Licensure, Certification, Registration** * Active Registered Nurse license from the State of… more
- McLaren Health Care (Grand Blanc, MI)
- …including role, responsibilities tools, and methodologies. _Required:_ + State licensure as a Registered Nurse ( RN ) + Bachelor's degree in nursing from ... Assigned:** 1. Assists in ensuring day-to-day activities of the Denial Appeal department are conducted in an...for potential denials management impact on medical necessity and DRG denials 4. Conducts patient medical record reviews and… more
- Stanford Health Care (Palo Alto, CA)
- …180 Days or + CCDS - Cert Clinical Document Spec required within 180 Days + RN - Registered Nurse - State Licensure And/Or Compact State Licensure preferred ... Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist II plays a critical role in the Revenue Cycle Denials… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for ... coding practices and compliance. **Essential Functions** + Performs inpatient denial reviews using ICD-10-CM/PCS and DRG validation...encoder. + Captures detailed data on reason for the denial and appeal status. + Consults with… more
- BronxCare Health System (Bronx, NY)
- …timely response by the department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have ... Appeal Manager is responsible to develop a strong appeal letter that will result in the denial...and data entry into an electronic database system. -The Appeal Manager should be a nurse who… more
- UNC Health Care (Kinston, NC)
- …preferred. + **EXPERIENCE** + Minimum 3-5 years of applied clinical experience as a Registered Nurse required. + 2 years utilization review, care management, or ... denials management preferred. + **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as a Registered Nurse in the state of North Carolina. **Job… more
- Houston Methodist (Sugar Land, TX)
- …care for government and nongovernmental payers preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... for level of care, medical necessity, and as appropriate, DRG recoupments/downgrades, and denials for no authorization. The Senior...denials, as appropriate. + Works with Case Management and appeal staff to ensure denial and/or utilization… more
- Datavant (Nashville, TN)
- …Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient admission. Experience with clinical ... our bold vision for healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of... Registered Nurse well versed in DRG downgrade denials and appeal writing for… more