• Registered Nurse RN Case Manager…

    AdventHealth (Winter Garden, FL)
    …patients who no longer meet medical necessity and escalates potential denials , documents avoidable days, and facilitates progression of care. + Collaborates ... primary care physician identification and scheduling of follow-up PCP and specialist appointments for post-hospital follow up care. + Ensures discharge disposition… more
    AdventHealth (10/11/24)
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  • Appeals Audit Specialist - McLaren Careers

    McLaren Health Care (Bay City, MI)
    …other related duties as required and directed. **Qualifications:** **_Required:_** + Registered Health Information Technician (RHIT), Licensed Practical Nurse ... resolution, process improvement initiatives, and response to inquiries to payer denials . **Essential Functions and Responsibilities as Assigned:** 1. Supports… more
    McLaren Health Care (09/26/24)
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  • Clinical Documentation Integrity Specialist

    Carle (Urbana, IL)
    …REQUIREMENTS Associate's Degree in Nursing or Doctorate CERTIFICATION & LICENSURE REQUIREMENTS Registered Nurse (RN) Illinois or Registered Health ... Clinical Documentation Integrity Specialist + Department: Health Information Management + Entity:...peers and providers we needed or requested. Reviews DRG denials and provides information to the denials more
    Carle (10/15/24)
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  • Utilization Review Specialist Senior

    BayCare Health System (Clearwater, FL)
    …Critical Care or Emergency Nursing RN. **Certifications and Licensures:** + Required RN ( Registered Nurse ) + Preferred ACM (Case Management) + Preferred CCM ... **BayCare Health System** is currently seeking a **Utilization Review Specialist Senior** to join our outstanding and compassionate team....2 years in Case Management + Preferred 3 years Registered Nurse in Critical Care or Emergency… more
    BayCare Health System (10/14/24)
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  • CDI Specialist

    Granville Health System (Oxford, NC)
    …CDI. Required:# Graduation from a Board-approved nursing program with current licensure as a Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the ... 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
    Granville Health System (09/05/24)
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  • Prior Authorization Specialist - Inpatient…

    Select Medical (West Orange, NJ)
    …of referrals scheduled for admission to the acute inpatient rehabilitation hospital. + Registered Nurse (RN) or Licensed Practical Nurse (LPN) required. ... and denials through TOC. **Qualifications** **Minimum Qualifications** + Licensure as a Registered Nurse or LVN/LPN is required + 2 years of direct… more
    Select Medical (09/07/24)
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  • Utilization Management Specialist NE

    Cleveland Clinic (Vero Beach, FL)
    …from an accredited school of professional nursing. + Current state licensure as a Registered Nurse (RN). + Basic Life Support (BLS) certification through the ... information to the payer, UM data collection and reporting, concurrent denials appeals process, clinical team interaction, Physician Adviser interaction and special… more
    Cleveland Clinic (10/31/24)
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  • Clinical Documentation Specialist III

    Tufts Medicine (Burlington, MA)
    …**Job Description** **Minimum Qualifications:** 1. Bachelor's Degree in Nursing 2. Active Registered Nurse (RN) license in Massachusetts or compact state 3. ... **Job Profile Summary** The role of the Clinical Documentation Integrity (CDI) Specialist III is responsible for concurrent and retrospect review and analysis of the… more
    Tufts Medicine (11/08/24)
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  • Housing Specialist

    Project Renewal, Inc. (Bronx, NY)
    …psychiatric services are provided Monday through Friday, staffed by a psychiatrist, nurse practitioner, registered nurse , and a licensed practical ... Housing Specialist Shelter- Ana's Place, 4380 Bronx Blvd, Bronx,...tracking system for submitted applications, interviews, and selections or denials . Performs follow-up to any denial of housing applications… more
    Project Renewal, Inc. (08/23/24)
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  • Prior Authorization Specialist

    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 ... joint venture with Select Medical & Banner Health Phoenix, Arionza **Prior Authorization Specialist / Payor Relations Specialist ** **Remote position - Must live… more
    Select Medical (11/01/24)
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