• Denials and Appeals Nurse

    Dayton Children's Hospital (Dayton, OH)
    Facility:Work From Home - OhioDepartment:Utilization Review TeamSchedule: Full timeHours:40Job Details:Reporting to the Manager of Utilization Management and in ... and Resource Management; supports the development and implementation of a comprehensive denials management program. This role functions as a hospital liaison with… more
    Dayton Children's Hospital (11/05/24)
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  • Clinical Denials Specialist

    Insight Global (Skokie, IL)
    Job Description Insight Global is looking for a clinical denials specialist to join the team at one of your healthcare clients in Chicago. As a Clinical Denials ... the denials team to review and analyze denials from a clinical perspective. This person will be...clinical perspective. This person will be responsible for preparing appeals and communication with the clinical team members. With… more
    Insight Global (10/04/24)
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  • Appeals Manager, Department of Utilization…

    BronxCare Health System (Bronx, NY)
    Overview Assists in the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute ... improve outcomes. - Maintains an excel log related to denials / appeals activities in order to monitor successful...Regular Full -Time Division Bronxcare- Yonkers Max USD $97,125.00/Yr. Shift Day Shift Department : Name Appeals Department… more
    BronxCare Health System (09/18/24)
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  • Outpatient Denial/ Appeals Specialist- RN

    Carle (Urbana, IL)
    Outpatient Denial/ Appeals Specialist- RN + Department: Revenue Cycle - CFH_10_19 + Entity: Champaign-Urbana Service Area + Job Category: Clerical/Admin + Employment ... Type: Full - Time + Job ID: 44345 + Experience...Weekend Requirements: no + Other Posting Information: Registered Professional Nurse (RN) License Illinois upon hire. + Holiday Requirements:… more
    Carle (08/23/24)
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  • Utilization Mgmt ED RN - Case Management…

    Stanford Health Care (Palo Alto, CA)
    …criteria and guidelines to optimize patient outcomes and manage healthcare costs. 4. Denials and Appeals Management: Address and manage denials by ... Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN) will be responsible for ensuring the efficient and effective… more
    Stanford Health Care (09/21/24)
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  • AVP Care Coordination

    Nuvance Health (Danbury, CT)
    …leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff while partnering with ... 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 (10/26/24)
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  • Utilization Review Nurse Coordinator (40…

    State of Connecticut, Department of Administrative Services (East Hartford, CT)
    …- is accepting applications for a full -time Utilization Review Nurse Coordinator ... Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 241106-5613FP-001...Regional Directors Office, East Hartford, CT. Position Highlights: + Full -time, 40 hours per week + First (1st) shift… more
    State of Connecticut, Department of Administrative Services (11/07/24)
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  • Supervisor Registered Nurse Case Manager

    HCA Healthcare (Houston, TX)
    …criteria and against established critical pathways. + Reviews and, if necessary, appeals Medicare/Medicaid and Managed Care denials . + Monitors for ... Health Assistance Fund that offers free employee-only coverage to full -time and part-time colleagues based on income. Learn more...nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want… more
    HCA Healthcare (08/28/24)
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  • Nurse Manager - Behavioral Health (Generous…

    Glens Falls Hospital (Glens Falls, NY)
    …charge discrepancies, CCI edits, and charge review * Serve as a clinical resource for appeals and denials * Review/update of Charge Master * Monitor and reports ... is seeking a strategic, forward thinking, and motivated Registered Nurse with leadership experience to join as our next...summary of these offerings, which are available to active, full -time and part-time employees who work at least 30… more
    Glens Falls Hospital (08/27/24)
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  • RN Registered Nurse - Utilization Review

    Ascension Health (Manhattan, KS)
    …related to coding, medical records/documentation, precertification, reimbursement and claim denials / appeals . + Assess and coordinate discharge planning needs ... **Details** + **Department:** Utilization Management + **Schedule:** Full Time, 40 hours weekly, Monday - Friday 7:30am - 4pm + **Hospital:** Ascension Via Christi… more
    Ascension Health (09/13/24)
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