- SSM Health (OK)
- …Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse ( RN ) Issued by Compact State + Or + ... or WI)* Qualifications: 2+ years of Utilization Review experience, denials and appeals experience, and knowledge of...Registered Nurse ( RN ) - Missouri Division of Professional… more
- St. Mary's Healthcare (Amsterdam, NY)
- …of nursing required. Licensure / Certification / Registration: Required Credential(s): * Registered Nurse credentialed from the New York Board of Nursing. ... denials and audit requests and coordinates attempts to overturn denials by drafting appeals , negotiating with payers, or following up with payer utilization… more
- R1 RCM (Salt Lake City, UT)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Appeals Nurse ** , you will help our hospital clients by ... **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct a detailed review...at telephonic hearings if needed. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
- BronxCare Health System (Bronx, NY)
- …special projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate ... Assists in the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care… more
- WellSpan Health (York, PA)
- …Required + 3 years Utilization Management Experience. Preferred Licenses: + Licensed Registered Nurse Preferred Knowledge, Skills, and Abilities: + Advanced ... Responsibilities + Oversees the utilization management process for preauthorization, concurrent review, denials and appeals for System acute care facilities. +… more
- University of Washington (Seattle, WA)
- …changes impacting revenue cycle **REQUIREMENTS** + Active licensure to practice as a Registered Nurse in Washington State + Bachelor's degree in Nursing + ... SERVICES Department** has an outstanding opportunity for a **CLINICAL APPEALS AND DISPUTES NURSE ** **Work Schedule** +...payer decisions in a timely manner + Review clinical denials and initiate appeals process + Conduct… more
- Stanford Health Care (Palo Alto, CA)
- …**This is an onsite Stanford Health Care job.** **A Brief Overview** The Utilization Management Registered Nurse (UM RN ) will be responsible for ensuring the ... to optimize patient outcomes and manage healthcare costs. 4. Denials and Appeals Management: Address and manage...systems and other healthcare software. **Licenses and Certifications** + Nursing/ RN - Registered Nurse -… more
- Ascension Health (Birmingham, AL)
- …**Requirements** Licensure / Certification / Registration: + Licensed Associate Professional Registered Nurse credentialed from the Alabama Board of ... related to coding, medical records/documentation, precertification, reimbursement and claim denials / appeals . + Assess and coordinate discharge planning needs… more
- Ascension Health (Manhattan, KS)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing ... related to coding, medical records/documentation, precertification, reimbursement and claim denials / appeals . + Assess and coordinate discharge planning needs… more
- Brockton Hospital (Brockton, MA)
- …responsibilities. EDUCATION: + RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts EXPOSURE CATEGORY: It is ... external review agencies, to coordinate activities involved in medical record review, denials , appeals and reconsideration hearings. Works closely with the… more