- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials ... JOB DUTIES AND RESPONSIBILITIES: + Reviews all Inpatient Retroactive Denials in the Denials Management ...monotony. EDUCATION: Graduate of an accredited professional nursing program. Registered nurse with current license to practice… more
- Catholic Health Initiatives (Omaha, NE)
- …as assigned by the manager. **Qualifications** **Required:** + Minimumthree (3)yearsclinical experience as Registered Nurse ( RN ) required. + RN license ... **Overview** The Denials RN is responsible for managing... experience preferred. + Minimum Three (3) years utilization management experience preferred + Denials management… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview Director of Clinical Denials Management and Audit supervises a team of RN /LPN clinical reviewers as well as ... for all payor types striving to minimize lost revenue. Conducts analysis on denials and appeals and identifies trends that present process improvement and revenue… more
- UNC Health Care (Goldsboro, NC)
- …work activities. Responsibilities: 1. Provides leadership, clinical expertise and organization to the Denials Management Team. 2. Stays up to date and proactive ... Minimum 3-5 years of applied clinical experience as a Registered Nurse required. * 2 years utilization...or compliance experience preferred. * Minimum 1 year clinical denials management preferred. Knowledge, Skills and Abilities… more
- Beth Israel Lahey Health (Plymouth, MA)
- …making a difference in people's lives.** MANAGER,UTILIZATION REVIEW & DENIALS MGMT **Job Description:** Beth Israel Deaconess Hospital-Plymouth recognizes Integrity, ... regarding UR and the analysis, resolution, monitoring & reporting of clinical denials . + Maintains current knowledge of payer contract changes as they pertain… more
- AdventHealth (Altamonte Springs, FL)
- …2 years utilizing InterQual and/or MCG . Minimum of three (3) years' experience as Registered Nurse ( RN ) in an acute clinical setting . Clinical experience ... contribute:** This position is responsible for investigating and appealing post-remit denials for all Inpatient and Outpatient clinical services across the system,… more
- Nuvance Health (Danbury, CT)
- …in nursing, health administration, or a related field preferred * Current licensure as a registered nurse ( RN ) * Minimum of 5 years of clinical experience ... and strategy for system-wide care coordination, encompassing utilization review (UR), denials management , discharge planning, social work, and non-clinical… more
- LifePoint Health (Brentwood, TN)
- …an acute care setting managing utilization review, medical necessity and denials management .Experience leading education training programs and/or community ... (ACM) or Commission for Case Manager (CCM) preferred. * Licenses:*Current licensure as a Registered Nurse in state of residence. *Why choose us:* As a team… more
- Trinity Health (Farmington Hills, MI)
- …professional behavior. **MINIMUM QUALIFICATIONS** Must possess a demonstrated knowledge of denial management functions. Registered Nurse and a graduate of ... Day Shift **Description:** **POSITION PURPOSE** Responsible for reviewing all post-billed denials (inclusive of clinical denials ) for medical necessity and… more
- University of Miami (Miami, FL)
- …the revenue cycle department to ensure denial prevention and to analyze causes of denials , while assisting with denials management and ensuring financial ... or other relevant field. Certification and Licensing: Valid State of Florida Registered Nurse license or Florida Licensed Clinical Social Worker Experience:… more