- Nuvance Health (Danbury, CT)
- …delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, ... * *Hybrid/Remote* * *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions...initial status is to be re-considered. * Identify incomplete clinical reviews in work queues and complete them within… more
- Nuvance Health (Danbury, CT)
- …Hours 5-9pm- Rotate Weekends/Evenings* *Summary:* Provides high quality administrative support to Clinical Denial Prevention & Appeals Specialist RNs, ... or other absences. Provide daily administrative assistance to Denial Prevention leadership and clinical reviewers. Manage incoming...Business Office related to appeals , denial and clinical reviews 9. Reviews new denials and… more
- Hartford HealthCare (Farmington, CT)
- …of medical records, coding, and clinical documentation to validate or appeal payer denials . . Prepare, document, and submit appeals for DRG denials , ... related to denial turnaround times, appeal success rates, and denial reduction targets. * Denials Prevention * . Analyze denial patterns to identify root causes… more
- Nuvance Health (Danbury, CT)
- …strategic leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non- clinical support staff while ... Leader* will be responsible for leading a team encompassing utilization review and denials / appeals specialists and will need to foster a culture of… more
- Nuvance Health (Danbury, CT)
- …admission criteria for all levels of care) * Understanding of approaches to denials management * Familiarity with clinical documentation requirements * Working ... expertise related to appropriate utilization/level of care (LOC) and appropriate clinical documentation. Provides oversight for other Physician Advisors for both the… more
- The Cigna Group (Bloomfield, CT)
- …prior authorization tools + Experience with prior authorization appeals and denials + Experience working with clinical EMR systems and/or Infertility is ... + Insurance Inquiries/benefit checks. + Prior Authorization submission, follow up and appeals as needed. + Juggle multiple tasks without sacrificing attention to… more