- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials ... and tracks outcomes regarding appeal process. Assists billing staff regarding outpatient denials for experimental, coding or other issues that may require record… more
- Penn Medicine (Lancaster, PA)
- …duties as assigned. Responsibilities: Minimum Required Qualifications: + Current licensure as a Registered Nurse , issued by the Pennsylvania Board of Nursing + ... you living your life's work? Summary: + Position Summary: The Utilization Management Specialist - Denials is responsible for evaluating medical records to… more
- AdventHealth (Bolingbrook, IL)
- …skills . Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associate's 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
- City and County of San Francisco (San Francisco, CA)
- …At least one (1) year of experience working as a Registered Nurse SPECIALTY REQUIREMENTS: + Clinical Documentation Specialist (CCDS) certification + At least ... LICENSE: Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License (**IMPORTANT: Be sure to include your… more
- Baptist Memorial (Memphis, TN)
- Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary * Position may be filled in Memphis, TN; Jackson , MS The ... Denial Mitigation-Appeal Specialist II RN serves in a key...along to healthcare insurance providers in response to post-claim denials received by BMHCC. Physician Advisor communication may be… more
- Baptist Memorial (Memphis, TN)
- …Summary * The position may be filled in Memphis, TN; Jackson, MS The Denial Mitigation-Appeal Specialist II RN serves in a key role of the BMHCC revenue cycle as ... in order to defend our revenue. The Denial Mitigation-Appeal Specialist II RN reviews the denial received...along to healthcare insurance providers in response to post-claim denials received by BMHCC. Physician Advisor communication may be… more
- HonorHealth (AZ)
- …1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required ... more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of...from an accredited NLN/CCNE institution Required Experience 3 years Registered Nurse in an acute care setting.… more
- MaineGeneral Health (Augusta, ME)
- Job Summary: MaineGeneral Health is seeking a qualified RN Clinical Appeals Specialist to support our Revenue Cycle team by reviewing denied insurance claims and ... alignment with MaineGeneral's mission of exceptional patient care Job Description: Position: RN Clinical Appeals Specialist Location: Alfond Center for Health,… more
- UPMC (Pittsburgh, PA)
- … Health Information Administrator OR Registered Health Information Technician (RHIT) OR Registered Nurse ( RN ) + Act 34 *Current licensure either in ... UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our... (CCS) OR Certified Professional Coder (CPC) OR Certified Registered Nurse Practitioner OR Doctor of Medicine… more
- Granville Medical Center (Oxford, NC)
- …of CDI. Required: Graduation from a Board-approved nursing program with current licensure as a Registered Nurse ( RN ) or Licensed Practical Nurse (LPN) in ... Summary : The CDI Specialist is responsible for improving the overall quality...Present on Admission indicators. * Obtains documentation relevant to denials avoidance related to the Recovery Audit program, the… more
- Community Health Systems (Franklin, TN)
- …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to… more
- Granville Health System (Oxford, NC)
- …of CDI. Required:# Graduation from a Board-approved nursing program with current licensure as a Registered Nurse ( RN ) or Licensed Practical Nurse (LPN) ... Summary:#The CDI Specialist is responsible for improving the overall quality...of Present on Admission indicators. #Obtains documentation relevant to denials avoidance related to the Recovery Audit program, the… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Clinical Documentation Integrity Specialist Part Time, 48 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's ... to be named a Forbes "Best Employer" seven times. Position Summary: The CDI Specialist serves as a liaison between the physicians and hospital departments to promote… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …Therapy and/or Prior Authorization experience is preferred. + Licensed as a Registered Nurse in the Commonwealth of Massachusetts preferred. **KNOWLEDGE, SKILLS, ... The Cell Therapy Clinical Authorization Specialist is responsible for the comprehensive coordination and...initial and ongoing authorizations, monitor payer-specific requirements, and resolve denials and claim issues to ensure timely access to… more
- Select Medical (Peoria, AZ)
- …14. Performs other duties as requested. **Qualifications** **Minimum Qualifications** + Licensure as a Registered Nurse or LVN/LPN is required + 2 years of of ... Select Medical & Banner Health Peoria, AZ **Prior Authorization Specialist ( RN or LPN ) -...as well as billing/reimbursement requirements. 12. Tracks approval and denials through TOC. 13. Ensure outstanding customer service for… more
- Access Dubuque (Dubuque, IA)
- …Accounting Specialist O'Connor, Brooks & Co, PC Certified Medical Assistant/LPN/ RN - Orthopaedics Medical Associates RN -5N Medical/Surgical UnityPoint Health ... Medical Billing Specialist **Unified Therapy Services** 1 Positions ID: 68838...most of the time focused on handling follow-ups and denials , utilizing denial management to optimize resolution. + Researches… more
- Catholic Health Initiatives (Omaha, NE)
- **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and optimize hospital ... experience.** Medical Coding experience is a plus! As our Utilization Review RN , you will be responsible for conducting comprehensive reviews of medical records… more
- Penn Medicine (Philadelphia, PA)
- …8a-4:30p, Remote The Health Information Management (HIM) Clinical Documentation Specialist will oversee organization-wide system for improving clinical documentation ... departmental and health system quality initiatives. Process clinical validation denials by disputing payer payment reductions when appropriate through identification… more
- Nuvance Health (Danbury, CT)
- …Preferred : Two Years of Utilization Review experience Required : CT Registered Nurse License Working Conditions: Manual: significant manual skills/motor coord ... every 3rd weekend rotation Summary: The purpose of the Utilization Management Nurse is to support the physician, the interdisciplinary team, and organization with… more
- Independent Health (Buffalo, NY)
- … Health Information Technician (RHIT), Certified Clinical Documentation Specialist (CCDS), American Health Information Management Association (CCS-H, CCS-P), ... growth, innovation and collaboration. **Overview** The Clinical & Coding Specialist -Senior will be responsible for reviewing coding and clinical...Denials and Appeals Management (C-DAM), or NYS licensed RN or LPN required. LPN or RN … more