- RestoraCare Staffing (Houston, TX)
- RestoraCare Staffing is seeking a Registered Nurse (RN) Case Management for a nursing job in Houston, Texas.Job Description & RequirementsSpecialty: Case ... of Social Work program. Licenses/Certifications: Current and valid license to practice as a Registered Nurse in the state of Texas or Current and valid license… more
- Trinity Health (Farmington Hills, MI)
- …Work Remote Position (Pay Range: $34.9314-$52.3971) Responsible for reviewing all post-billed denials (inclusive of clinical denials ) for medical necessity ... location responsible for identifying and determining root causes of clinical denials . Responsible for leveraging clinical...Must possess a demonstrated knowledge of denial management functions. Registered Nurse and a graduate of an… more
- Catholic Health Initiatives (Omaha, NE)
- …assigned by the manager. **Qualifications** **Required:** + Minimumthree (3)yearsclinical experience as Registered Nurse (RN) required. + RN license + BLS ... The RN has an integral role within the revenue cycle by providing clinical expertise in the denials management process. The Denials RN performs a root cause… more
- 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
- AdventHealth (Tampa, FL)
- …role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by analyzing patient records to ... algorithmic logic of the XSOLIS Cortex platform, utilizing key clinical data points to assist in status and level.... Current and valid license to practice as a Registered Nurse (ADN or BSN) required. .… more
- Ascension Health (Glendale, WI)
- …and identify savings potential. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Wisconsin Board of Nursing ... with your Talent Advisor for additional specifics._ **Responsibilities** Coordinate payer denials and appeals, respond to insurance company requests for medical… more
- Ascension Health (Nashville, TN)
- …/ Certification / Registration: + One or more of the following required: + Registered Nurse credentialed from the Tennessee Board of Nursing or current home ... with your Talent Advisor for additional specifics._ **Responsibilities** Coordinate payer denials and appeals, respond to insurance company requests for medical… more
- 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...family and payer. Work is typically performed in a clinical and office environment. Accountable for satisfying all job… more
- 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...and initiate the admission process. Duties include: + Conducts clinical assessments + Monitor e-fax and email for notification… more
- Penn State Health (Hershey, PA)
- … Appeals Nurse ( Clinical Documentation / Clinical Validation Reviews) **Location** US:PA:Hershey | Registered Nurse | Full Time **Req ID** null ... Nursing required. + Currently licensed to practice as a Registered Nurse by state of employment or...Nurse Licensure Compact. **PREFERRED QUALIFICATION:** + Experience in Clinical Documentation. **WHY PENN STATE HEALTH?** Penn State Health… more
- AdventHealth (Hinsdale, IL)
- …AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse (RN) . Two (2) years of medical/hospital nursing experience ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** . State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- AdventHealth (Hinsdale, IL)
- …AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse (RN) . Two (2) years of medical/hospital nursing experience ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- Bon Secours Mercy Health (Boardman, OH)
- …* Be mindful of revenue cycle components including scheduling, registration, clinical coverage/treatment, documentation, billing, collections, and denials . * ... effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. **Summary of Primary Function/General Purpose of… more
- AdventHealth (Ocala, FL)
- …AND EXPERIENCE REQUIRED: * Associates Degree Nursing or RN Diploma degree * Registered Nurse (RN) * Two (2) years of medical/hospital nursing experience ... and communicates these goals and preferences to the multidisciplinary team. Incorporate clinical , social and financial factors into the transition of care plan.… more
- AdventHealth (Orlando, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under the general… more
- Alameda Health System (San Leandro, CA)
- …made to discontinue the process; assumes the responsibility for coordinating and appealing clinical denials per department policy; develops any appeal letters to ... Care Management Clinical Appeals Specialist + San Leandro, CA +...or health plan. Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California,… more
- CDPHP (Albany, NY)
- …internal and external constituents on CDPHP guidelines, policies, and procedures. QUALIFICATIONS + Registered Nurse or Licensed Practical Nurse with a ... a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review...years of acute care experience is required as a Registered Nurse . + Minimum five (5) years… more
- Rush University Medical Center (Chicago, IL)
- …workshops. **Other information:** **Required Job Qualifications:** *Current license in Illinois as Registered Nurse (RN). *Ability to perform all job components ... financial and clinical needs throughout the continuum of care. The Nurse Care Manager 1 functions as a liaison between patients, physician practices, the… more
- R1 RCM (Boise, ID)
- …Supervisor** , you will help support clinicians who conduct a comprehensive review of clinical denials and formulate appeals based on clinical documentation, ... identify targeted areas for additional support and engagement. **Required Skills:** + Active Registered Nurse license For this US-based position, the base pay… 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 state 3. ... completeness, and accuracy of medical record documentation, obtains appropriate clinical documentation through extensive interaction with physicians, nursing staff,… more
