• Manager - Utilization Review…

    Beth Israel Lahey Health (Plymouth, MA)
    …making a difference in people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth ... Community!** **In your role as a Utilization Review & Denials Management Manager , you will:** + Directs...Reviews and determines appropriate strategy in response to reimbursement denials . + Responsible for appeals and follow… more
    Beth Israel Lahey Health (07/29/25)
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  • Registered Nurse or Physical Therapist…

    CenterWell (Boston, MA)
    …responding to, managing and monitoring all payer requests for additional documentation (ADR), appeals and denials . Works with branch staff to gather required ... to develop appropriate and timely responses. + Responsible for constructing response to denials and appeals , utilizing any federal guidelines or local coverage… more
    CenterWell (07/30/25)
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  • Care Transitions Jobs

    Beth Israel Lahey Health (Plymouth, MA)
    …is expanding its **Care Transitions Department** and seeking an experienced ** Manager of Utilization Review & Denials Management** and **Utilization ... for level of care and continued stay * Lead appeals of clinical denials and collaborate with...or other case management certification preferred or in progress ** Manager - Utilization Review & Denials Management**… more
    Beth Israel Lahey Health (07/03/25)
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  • Per Diem RN Case Manager , Utilization…

    Children's Hospital Boston (Boston, MA)
    …authorizations for the appropriate level of care for admissions and with post-discharge appeals of payer denials . They identify and implement initiatives to ... 80451BRJob Posting Title:Per Diem RN Case Manager , Utilization Management/ReviewDepartment:Patient Services-Patient Care OperationsAutoReqId:80451BRStatus:Part-TimeStandard Hours per… more
    Children's Hospital Boston (06/16/25)
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  • Manager Utilization Management

    Beth Israel Lahey Health (Burlington, MA)
    …Manages UM department in the context of other Revenue Cycle functions such as Denials & Appeals , Patient Access, Authorization Management & review, HIM, Coding & ... Billing. Close collaboration with the Physician Advisors, Collaborates and helps facilitate the Utilization Review Committee. Continuously monitors processes for opportunities for improvement within an interdisciplinary team and integrated Revenue Cycle… more
    Beth Israel Lahey Health (06/06/25)
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  • Receivable Specialist

    Baystate Health (Springfield, MA)
    …Accounts Receivables Manager , Supervisor and Team Lead; identifies denials / appeals , makes appropriate system changes, completes balance adjustments, ... documents work-in-process, obtains materials to complete the collection and/or appeals process and mentors' colleagues. Other related duties as required.… more
    Baystate Health (07/16/25)
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  • Cardiovascular Medical Coder (remote)

    Cognizant (Boston, MA)
    …manage appeals , working with various departments to prevent future denials . + Review documentation to code diagnosis and procedures specific to cardiovascular ... Coding Professional you will be responsible for reviewing/resolving coding denials in the cardiovascular specialty. You will be a...a team in a fast-paced environment. + Interacting with manager /team members on scheduled time off and breaks and… more
    Cognizant (07/18/25)
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  • Registered Nurse - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …multidisciplinary team to assess and improve the denial management, documentation, and appeals process. + Collaborates with UR Manager and/or physician advisor ... clinical knowledge with billing knowledge to review, evaluate, and appeal clinical denials related to the care provided to the hospitalized patient. + Conducts… more
    Beth Israel Lahey Health (05/17/25)
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