• Registered Nurse Clinical…

    Catholic Health (Buffalo, NY)
    …as related to DRG and level of care denial trends. Responsibilities: EDUCATION + Registered Nurse with a current New York State license + Bachelor of ... cause and process improvement opportunities to eliminate recurring clinical denials . The position acts as a liaison between front-end...areas and third party payers in scenarios related to denials and appeals. This position educates all members of… more
    Catholic Health (02/14/24)
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  • Intake Psychiatric Registered Nurse

    Houston Behavioral Healthcare Hospital (Houston, TX)
    …safety. Houston Behavioral Healthcare Hospital is currently recruiting for full-time Intake Registered Nurse , 12hr shifts including alternating weekends. The MOT ... Intake Registered Nurse is primarily responsible managing the...Intake Registered Nurse is primarily responsible managing the MOT process The...for admission. + Notifies Director of Intake of any denials of admissions + The RN must… more
    Houston Behavioral Healthcare Hospital (03/28/24)
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  • Registered Nurse RN Care…

    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 (01/26/24)
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  • Registered Nurse RN Care…

    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 (01/25/24)
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  • Registered Nurse ( RN ) - PFS…

    University of Virginia (Charlottesville, VA)
    …payor side will also be considered. Licensure: Licensed to practice as a Registered Nurse in the Commonwealth of Virginia PREFERRED REQUIREMENTS: Experience in ... oral and written, creates and submits appeal letters as needed to overturn denials . Utilizes critical thinking and root cause problem solving methodology to discern… more
    University of Virginia (03/22/24)
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  • Registered Nurse ( RN ) Care…

    Geisinger (Middleburg, PA)
    …Experience Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic Life ... administrative and medical channels to avoid third party payer denials . + Maintains awareness of all concurrent denials...but not required. + Required Experience: 3 years of RN work experience + To learn more about Geisinger… more
    Geisinger (03/21/24)
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  • Registered Nurse ( RN ) Care…

    Geisinger (Bloomsburg, PA)
    …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... administrative and medical channels to avoid third party payer denials . + Maintains awareness of all concurrent denials...but not required. + Required Experience: 3 years of RN work experience + To learn more about Geisinger… more
    Geisinger (01/17/24)
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  • Denials Management RN

    Catholic Health Initiatives (Omaha, NE)
    …as assigned by the manager. **Qualifications** **Required:** + Minimumthree (3)yearsclinical experience as Registered Nurse ( RN ) required. + RN license ... **Overview** The Denials RN is responsible and accountable for receiving, processing and documenting all concurrent denials for assigned facilities. The … more
    Catholic Health Initiatives (02/23/24)
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  • Registered Nurse ( RN ) Wound…

    Bon Secours Mercy Health (Youngstown, OH)
    …operational excellence. **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
    Bon Secours Mercy Health (01/31/24)
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  • Case Manager Registered Nurse

    Beth Israel Lahey Health (Beverly, MA)
    …Hours:** 40 **Work Shift:** Day (United States of America) Case Manager RN **Job Description:** **Case Manager RN ** **Position Summary:** Case managers ... and retrospective review to assure appropriate utilization, assessment, prevention of denials and coordination of discharge options. They are required to follow… more
    Beth Israel Lahey Health (02/01/24)
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  • Registered Nurse - Care in…

    Veterans Affairs, Veterans Health Administration (Omaha, NE)
    Summary The VA Care in the Community Nurse (CITC) Registered Nurse will assist in planning, designing, integrating, implementing, modifying and evaluating ... well-being. VA offers a comprehensive total rewards package: VA Nurse Total Rewards As a CITC RN ,...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (03/21/24)
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  • Registered Nurse Utilization Review

    Ascension Health (Jacksonville, FL)
    …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse obtained prior to hire date or job transfer ... related to coding, medical records/documentation, precertification, reimbursement and claim denials /appeals. + Assess and coordinate discharge planning needs with...date. Licensed as a Registered Nurse in Florida. Credentialed from State… more
    Ascension Health (02/24/24)
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  • Registered Nurse - Clinical…

    Ascension Health (Birmingham, AL)
    …Specialists obtained prior to hire date or job transfer date required. + Registered Nurse credentialed from the Alabama Board of Nursing obtained prior ... the following qualities: 4-5 years of CDI experience CCDS certification Denials experience NCD/LCD Denial prevention Strong knowledge in HACs/PSI **Benefits** Paid… more
    Ascension Health (03/05/24)
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  • Registered Nurse - Utilization…

    Beth Israel Lahey Health (Plymouth, MA)
    …clinical knowledge with billing knowledge to review, evaluate, and appeal clinical denials related to the care provided to the hospitalized patient. + Conducts ... job that may reasonably be required._ **Education/Experience Required:** + Current MA RN licensure + Bachelor's Degree in Nursing or advanced degree in healthcare… more
    Beth Israel Lahey Health (03/21/24)
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  • Clinical Payment Resolution Specialist (Hospital…

    Trinity Health (Farmington Hills, MI)
    …**MINIMUM QUALIFICATIONS** Must possess a demonstrated knowledge of denial management functions. Registered Nurse and a graduate of an accredited school of ... Work Remote Position (Pay Range: $34.0638-$51.0961) Responsible for reviewing all post-billed denials (inclusive of clinical denials ) for medical necessity and… more
    Trinity Health (03/13/24)
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  • Case Manager RN PD

    Penn Medicine (Plainsboro, NJ)
    …reimbursement, proactively identify potential denials in order to avoid non-appealable denials ; Credentials: + Registered Nurse - NJ (Required) + ... National Case Management certification preferred; or obtained within two years of employment. Education or Equivalent Experience: + Bachelor of Arts or Science (Required) + BSN degree required Minimum of 3 years Medical-Surgical experience required; Case… more
    Penn Medicine (03/22/24)
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  • RN Utilization Management - Per Diem

    Guthrie (Sayre, PA)
    Summary The Registered Nurse ( RN ) Utilization Management (UM) in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, ... of patient status. + Collaborate and set standards with registered nurse ( RN ) case managers...of discussion and appeal letters for Medicare/Medicaid medical necessity denials . + Assist with developing and maintaining efficient and… more
    Guthrie (03/12/24)
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  • RN Case Manager

    Actalent (Rancho Mirage, CA)
    …requirements. This position complies with the scope of services defined by the Registered Nurse RN state licensure requirements. This position integrates ... using the data to address opportunities for improvement. Prevents denials and disputes by communicating with payers and documenting...Registered Nurse Additional Skills & Qualifications: Registered Nurse - RN Experience… more
    Actalent (03/26/24)
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  • Utilization Review RN

    Billings Clinic (Billings, MT)
    …Licenses * Healthcare Provider CPR Certification At hire * Current Montana license as a Registered Nurse At hire * Current working knowledge of payer and managed ... starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Utilization Review RN CARE MANAGEMENT (Billings Clinic Main Campus) req7327 Shift:… more
    Billings Clinic (03/13/24)
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  • Inpatient RN Case Manager

    Actalent (San Diego, CA)
    registered nurse , data entry, utilization management Additional Skills & Qualifications: Registered Nurse - RN NEED ACUTE EXPERIENCE Experience Level: ... Requirements: Must have 2+ years of acute RN Case Management experience in a hospital setting...status and patient classification. Skills: case management, acute care, registered nurse , data entry, utilization management, Care… more
    Actalent (03/23/24)
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