- State of Massachusetts (Boston, MA)
- …at least (A) three years of full-time, or equivalent part-time, experience as a registered nurse in a recognized hospital, clinic or medical facility and (B) ... an approved school of nursing must have applied for the first available registered nurse examination. Special Requirements: Based on assignment, possession of a… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …experience is preferred. + **Certification/Licensure/Registration:** + Licensed as a Registered Nurse in the Commonwealth of Massachusetts preferred. ... will bring clinical expertise to the prior authorization and appeals processes and serve as a liaison and patient...+ Root causes claim denials, reprocesses, and submits claim appeals . + Creates drug cost estimates for both on-label… 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 ... agencies, to coordinate activities involved in medical record review, denials, appeals and reconsideration hearings. Works closely with the physician advisor to… more
- Beth Israel Lahey Health (Burlington, MA)
- …Degree, Master's Degree preferred **Licensure, Certification, Registration:** Current license as a Registered Nurse **Skills, Knowledge & Abilities** : + Current ... in the context of other Revenue Cycle functions such as Denials & Appeals , Patient Access, Authorization Management & review, HIM, Coding & Billing. Close… more
- Beth Israel Lahey Health (Plymouth, MA)
- …Plymouth and Barnstable counties. Our Nutrition Services Team consists of registered and licensed dietitians who provide expert nutritional interventions to improve ... and determines appropriate strategy in response to reimbursement denials. + Responsible for appeals and follow up on clinical denials escalated through a work queue,… more
- Beth Israel Lahey Health (Plymouth, MA)
- …Care Transitions team plays a vital role in ensuring seamless, patient-centered care. ** RN - Utilization Review** This role is ideal for nurses with strong ... for level of care and continued stay * Lead appeals of clinical denials and collaborate with physician advisors...* Integrate clinical and reimbursement knowledge for optimal outcomes ** RN Case Manager - Emergency Department UR & Discharge… more
- Beth Israel Lahey Health (Plymouth, MA)
- …team to assess and improve the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor regarding ... job that may reasonably be required._ **Education/Experience Required:** + Current MA RN licensure + Bachelor's Degree in Nursing or advanced degree in healthcare… more
- Commonwealth Care Alliance (Boston, MA)
- …* Translate regulatory updates into operational actions, collaborating with Claims, Appeals , UM, and Provider Services. * Conduct internal audits and retrospective ... record, (if applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer.… more
- Commonwealth Care Alliance (Boston, MA)
- …issues. + Collaborate closely with Provider Relations, Contracting, Payment Integrity, Appeals & Grievances, and Configuration teams to validate and resolve ... record, (if applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer.… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Primary responsibility for performing daily medical reviews, appeals as appropriate, correspondence regarding review determinations and physician ... record, (if applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer.… more
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