- St. Luke's University Health Network (Allentown, PA)
- …communities we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party ... 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
- 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 ... cause and bring about the best opportunity for fair reimbursement. The Clinical Denial Management Specialist will adhere to the AHS Compliance Plan and to all… 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
- Northwell Health (Melville, NY)
- …five (5) years of job entry date. + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as ... needed. + Prior experience in Case Management , Utilization Review, and Appeals/ Denials , highly preferred. *Additional Salary Detail The salary range and/or… more
- AdventHealth (Orlando, FL)
- …experiences you'll need to succeed:** **EDUCATION AND EXPERIENCE REQUIRED:** + Associates Degree Nursing or RN Diploma degree + Registered Nurse ( RN ) + ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- City and County of San Francisco (San Francisco, CA)
- …At least one (1) year of experience working as a Registered Nurse SPECIALTY REQUIREMENTS: + Clinical Documentation Specialist (CCDS) certification + At least ... LICENSE: Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License (**IMPORTANT: Be sure to include your… more
- HonorHealth (Scottsdale, AZ)
- …1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required ... more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of...accredited NLN/CCNE institution Required Experience 3 years as a Registered Nurse in an acute care setting… more
- Trinity Health (Maywood, IL)
- …and communication skills are necessary. + CPR (Cardiopulmonary Resuscitation) + Current Registered Nurse License State of Illinois + Specialty certification in ... hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist ** nurse works with the multidisciplinary team including physicians,… more
- AdventHealth (La Grange, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- Alameda Health System (San Leandro, CA)
- …at a medical group or health plan. Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California, Active BLS - Basic Life ... Care Management Clinical Appeals Specialist + San...denials with the attending physician and the Care Management physician advisor; prepares case reports; documents treatment plan,… more