- Rush University Medical Center (Chicago, IL)
- …origin, disability, veteran status, and other legally protected characteristics. **Position** Appeal Specialist RN **Location** US:IL:Chicago **Req ID** ... and procedures. **Other information:** **Required Job Qualifications:** * Licensed, registered nurse in the State of IL...follows up on appeals throughout entire process to ensure appeal has resulted in an overturned denial or has… more
- Baptist Memorial (Memphis, TN)
- …II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary The Denial Mitigation- Appeal Specialist II RN serves in a key role of the BMHCC revenue ... claims and denial resolution in order to defend our revenue. The Denial Mitigation- Appeal Specialist II RN reviews the denial received from the payer,… more
- Baptist Memorial (Memphis, TN)
- …II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary The Denial Mitigation- Appeal Specialist II RN serves in a key role of the BMHCC revenue ... claims and denial resolution in order to defend our revenue. The Denial Mitigation- Appeal Specialist II RN reviews the denial received from the payer,… more
- State of Colorado (CO)
- CDOC Registered Nurse ( Nurse I) Print...RN license. 07 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4762850) Apply CDOC Registered Nurse ( Nurse I) Salary $7,442.00 Monthly Location Statewide,… more
- State of Colorado (Denver, CO)
- CDOC Registered Nurse - Part-time - Denver Print...Yes + No 06 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4945982) Apply CDOC Registered Nurse - Part-time - Denver Salary...Colorado? If so, what state issued your license? 07 Nurse Licensure Compact: If appointed to an RN… more
- The County of Los Angeles (Los Angeles, CA)
- REGISTERED NURSE III (NON-COMPETITIVE) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3397421) Apply REGISTERED NURSE III ... SELECTION REQUIREMENTS: 1. A license to practice as a Registered Nurse issued by the California Board...variety of settings. + Serving as an expert or specialist who gives practical experience and training to a… more
- The County of Los Angeles (Los Angeles, CA)
- REGISTERED NURSE II (Non-competitive) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3398717) Apply REGISTERED NURSE II ... practice setting. + Serves as a preceptor: expert or specialist who gives practical experience and training to new...SELECTION REQUIREMENTS: Three years of full-time experience* as a Registered Nurse providing professional nursing care and… more
- 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 ... parties. Knowledge of state and federal laws relating to contracts and appeal processes is vital. Additional responsibilities include identification of root cause… more
- AdventHealth (Altamonte Springs, FL)
- …expertise and experiences you'll need to succeed:** . Bachelor's . 1 Related Experience . Registered Nurse ( RN ) . Extensive understanding of CPT, HCPCS, ICD, ... and bring about the best opportunity for fair reimbursement. The Clinical Denial Management Specialist will adhere to the AHS Compliance Plan and to all rules and… more
- HonorHealth (Scottsdale, 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
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and tracks ... outcomes regarding appeal process. Assists billing staff regarding outpatient denials for...an accredited, professional nursing program. + Must have current RN license to practice in the state of Pennsylvania… more
- Corewell Health (Royal Oak, MI)
- …care setting. Required + 5 years of relevant experience of education experience. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + ... ** 1-2 years of Pediatric experience preferred. Scope of Work: The NPD- Specialist develops tools, theories, skills and knowledge to advance the practice of the NPD… more
- City and County of San Francisco (San Francisco, CA)
- …and Certification: + Registered Nurse License: Possession of a valid California Registered Nurse ( RN ) license issued by the California Board of ... Registered Nursing; AND + Clinical Nurse Specialist Certificate: Possession of a valid...was not submitted or received. Terms of Announcement and Appeal Rights: Applicants must be guided solely by the… more
- Ascension Health (Baltimore, MD)
- …and salary range at the time of the offer._ **Responsibilities** Manage assigned Registered Nurse ( RN ) case managers, related activities and workflow ... planning, and length of stay. + Serve as content specialist for staff in the areas of utilization criteria,...management issues. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Maryland Board… more
- Ascension Health (Baltimore, MD)
- …development and evaluation of staff **Requirements** Licensure / Certification / Registration: + Registered Nurse obtained prior to hire date or job transfer ... troubleshooting problems, and ensuring effective resolution to maintain smooth operations. ** Registered Nurse , Certified Case Manager (CCM, ACM, URAC) preferred… more
- Corewell Health (Dearborn, MI)
- …+ Critical Care- CCU and Cardiac stepdown preferred. + previous teaching experience. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required ... educational process by selecting education content, materials, and techniques that can appeal to a diverse target audience in a positive learning environment.… 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 + ... living your life's work? Summary: + Position Summary: The Utilization Management Specialist - Denials is responsible for evaluating medical records to determine… more
- Intermountain Health (West Valley City, UT)
- …subject matter expert, resource and mentor to others within the RCO, clinical departments, Appeal RN 's, legal, IPAS and Payor Contracting on the art of ... **Job Description:** The RCO Appeals Hearing Specialist is responsible for investigating, coordinating and managing...with Intermountain Health legal team, Physician Advisors, and Appeals RN consultants in their various capacities. Fully remote… more
- Molina Healthcare (Columbus, OH)
- …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied ... Inquiries/Appeals. + Provides training, leadership and mentoring for less experienced appeal LVN, RN and administrative staff. **JOB QUALIFICATIONS** **Required… more
- Hospice of Michigan (Ann Arbor, MI)
- …CARE Model of Service: courtesy, acknowledgement, response and empathy. Qualifications: + Registered Nurse with a baccalaureate degree in nursing, preferably a ... Testing (CERT), Recovery Audit Contractor (RAC) etc., requests and participates in appeal processes. + Participates in the development and annual revision of Quality… more