- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is seeking a highly motivated and results-driven **UM RN Appeals Coordinator .** This role collaborates with clinical review staff, medical ... to ensure consistent clinical evaluation and processing of medical necessity appeals . Accurate documentation and detailed recordkeeping of notifications to members… more
- Nuvance Health (Danbury, CT)
- …Business Office related to appeals , denial and clinical reviews 9. Reviews new denials and appeal upheld cases in work queue and incoming fax queue. 10. Reviews ... Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, Physician Advisors (PAs) and other stakeholders in ensuring… more
- Community Health Systems (Franklin, TN)
- …denial and appeal status. + Consults with Coordinator and/or Director, Coding Denials and Appeals during any audit discrepancies. + Attends coding education ... of work products by the Coordinator and/or Director, Coding Denials and Appeals . + Partners with peers and Director to develop coder education based… more
- Community Health Systems (Antioch, TN)
- …in Artiva, HMS, Hyland, BARRT, and other host systems, ensuring timely follow-up on denials and appeals . + Conducts follow-up calls and payer portal research to ... **Job Summary** The Denial Coordinator is responsible for reviewing, tracking, and resolving...reviewing, tracking, and resolving denied claims, ensuring that appropriate appeals are submitted, and working closely with payers, internal… more
- St. Bernard's Medical Center (Jonesboro, AR)
- …monthly meetings with departments to discuss trends, opportunities, etc. Assists Revenue Integrity Coordinator with denials appeals . Close out each tracked ... Overall works to increase revenue capture. Assists Revenue Integrity Coordinator with Medical Center denials process as...Assists Revenue Integrity Coordinator with Medical Center denials process as needed. Facility resource for denials… more
- Community Health Systems (Franklin, TN)
- … ensures efficient and effective management of utilization review processes, including denials and appeals activities. This role collaborates with payers, ... for hospital admissions and extended stays. The Utilization Review Coordinator monitors and documents all authorization activities, assists with process… more
- Thrive Proactive Health (Virginia Beach, VA)
- …third-party billing partners while learning the ins and outs of insurance billing, denials , appeals , and patient financial support. This position is ideal for ... Management : Submit and follow up on claims, corrected claims, and appeals . + Denials & A/R Management : Investigate, appeal, and resolve denied claims; manage… more
- HCA Healthcare (Manchester, NH)
- …care like family! Jump-start your career as a Medical Staff Services Coordinator today with Catholic Medical Center. **Benefits** Catholic Medical Center, offers a ... may vary by location._ Come join our team as a Medical Staff Services Coordinator . We care for our community! Just last year, HCA Healthcare and our colleagues… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251212-5613FP-001 Location East Hartford, CT Date Opened 12/16/2025 12:00:00 AM Salary ... learn more about joining our team as a Utilization Review Nurse Coordinator ! The State of Connecticut (https://portal.ct.gov/) , Department of Developmental Services… more
- State of Connecticut, Department of Administrative Services (Middletown, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 251119-5613FP-001 Location Middletown, CT Date Opened 12/11/2025 12:00:00 AM Salary ... - is accepting applications for a Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=) (REGULATORY) position, located in Middletown, CT. New:… more
- Virtua Health (Moorestown, NJ)
- …open communication with management regarding billing and coding issues including documentation, denials / appeals , etc.* Follows up on assigned insurances on a ... and complete.* Analyzes, identifies and trends billing issues to proactively reduce denials and variances.* Works system generated reports such as residual balance,… more
- Sharp HealthCare (San Diego, CA)
- …benefits and accurately follows Health Plan and/or Medicare Guidelines when issuing denials .Ensures that all denials for medical necessity are issued under ... issued accurately and served timely to members or responsible party.Ensures that all denials for medical necessity are issued under the direction of the appropriate… more
- Roper St. Francis (North Charleston, SC)
- …with all payors to resolve appeals and find speedy resolution to denials . The Accounts Coordinator is responsible for managing UKG scheduling and time ... - 5:00 PM** **Job Summary** **:** The LifeLink Accounts Coordinator handles billing and follow-up of all LifeLink claims...enable claims to get paid timely and accurately. The coordinator will provide excellent customer service and support in… more
- Cardinal Health (Sacramento, CA)
- Coordinator , Benefits Eligibility and Authorization **_What Benefits Eligibility and Authorization contributes to Cardinal Health_** Practice Operations Management ... also obtain authorization for all requested procedures, tests, drugs, etc. The Coordinator , Benefits Eligibility and Authorization may be asked to perform other… more
- Highmark Health (Montpelier, VT)
- …workflow within the department. + Prioritize requests for drug authorizations or denials . + Review of prior authorization criteria for drug products. + Recommend ... for guidance and assistance as necessary. + Document all authorizations and denials completely, accurately, and in accordance with timelines as defined by state… more
- Guthrie (Binghamton, NY)
- …for review and determination of coverage of ordered medications. + Coordinate and complete appeals for denials as needed + Monitor and Review REMS clearance for ... that qualify Monday through Friday 8:00am-4:30pm Position Summary: The LPN Care Coordinator will assist the providers with medication refills, patient messages, in… more
- Robert Half Office Team (Blue Ash, OH)
- Description We are looking for a dedicated Insurance Referral Coordinator to join our client's team in Blue Ash, Ohio. This role involves managing prior ... Track authorization statuses and promptly notify healthcare teams regarding approvals, denials , or pending requests. * Stay informed about current insurance policies… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient ... documented in patient's medical records. + Reviews notices of potential denials and respond appropriately; ie facilitate Physician to Physician appeals… more
- University of Utah (Salt Lake City, UT)
- …account resolution of MAC 1 & 2 team members. + Monitor and resolve denials and appeals to ensure timely collection. + Maintain work queue expectations. ... + Identifies, analyzes, and researches frequent root causes of denials and develops corrective action plans for resolution of...its regulations may be referred to the Title IX Coordinator , to the Department of Education, Office for Civil… more
- Brockton Hospital (Brockton, MA)
- …external review agencies, to coordinate activities involved in medical record review, denials , appeals and reconsideration hearings. Works closely with the ... rounds. Proactively builds post hospital referrals and sends to the Transition Care Coordinator when indicated to facilitate timely discharge. Acts as a change agent… more
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