- McLaren Health Care (Grand Blanc, MI)
- …+ Associate's degree in nursing or healthcare related field **.** Current Registered Nurse license in the state of Michigan or possess a Doctor of Medicine ... **4 years of utilization management, case management, clinical documentation, and/or denials/ appeals experience in an acute healthcare facility** **.** American Case… more
- Corewell Health (Dearborn, MI)
- …when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization for care and ... care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan Upon Hire required + Basic Life… more
- Community Health Systems (Franklin, TN)
- …role conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers to facilitate efficient ... and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required + CCM -… more
- Brockton Hospital (Brockton, MA)
- …agencies, to coordinate activities involved in medical record review, denials, appeals and reconsideration hearings. Works closely with the physician advisor to ... EDUCATION: + RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts EXPOSURE CATEGORY: It is reasonable to… more
- Humana (Springfield, IL)
- …gaps in care and access. + Assists enrollees with filing grievances and appeals . + Provides information to enrollee related to MCO requirements, services, and ... social work, human services, or a related field. + An active, unrestricted Licensed Practical Nurse (LPN) in the state of Illinois with one (1) year of experience in… more
- Garnet Health (Middletown, NY)
- …the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, policies and procedures ... (CCDS) credentialed * Current license to practice as a Registered Professional Nurse in New York State required. Physical Requirements: Travel to multiple facilities… more
- Louisiana Department of State Civil Service (Shreveport, LA)
- …Health Services Department, including supervision of the Health Services Nurse , to ensure student clinical credentialing, immunization compliance, and onboarding ... coordinating responses to student issues such as probation, suspension, and progression appeals . *Collaborate with faculty and program directors to assess and report… more
- Baylor Scott & White Health (Dallas, TX)
- …+ Responsibility for the preparation of summaries and files for denials, appeals , medical advice, subrogation, and litigation. + Collection of documents and ... parties. + Maintain communication with doctors, attorneys, safety specialists, nurse specialists, and vendors. Provide prompt, economical, and professional handling… more
- San Antonio Behavioral Health (San Antonio, TX)
- …staff as needed. Essential Duties: + Collaborate and set standards with registered nurse (RN) case managers (CMs) and outcome managers to ensure that all ... of potential denials and respond appropriately; ie facilitate Physician to Physician appeals when appropriate and assist with construction of appeal letters. +… more
- Corewell Health (Royal Oak, MI)
- …when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization for care and ... management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan License Upon Hire required How Corewell… more