- Amaze Health (Denver, CO)
- …healthcare in America, one patient at a time. We're seeking a patient-focused Nurse Practitioner (NP) or Physician Assistant (PA) to join our growing team. In ... and communication. + Meaningful results: See your work translate into successful appeals , smoother referrals, and less stress for patients and families. Every… 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 ... cases that do not meet established guidelines for admission or continued stay. + Acts as a liaison between physicians and payers, coordinating peer-to-peer phone calls. + Collects and compiles data as required. _It is understood that this is a summary of key… 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 ... cases that do not meet established guidelines for admission or continued stay. + Acts as a liaison between physicians and payers, coordinating peer-to-peer phone calls. + Collects and compiles data as required. _It is understood that this is a summary of key… more
- Stanford Health Care (Palo Alto, CA)
- …the Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials. This position requires strong ... and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, coding...required within 180 Days or + RN - Registered Nurse - State Licensure And/Or Compact State Licensure required… more
- Independent Health (Buffalo, NY)
- …the collection and review of medical records specific to quality complaints/grievances and appeals as indicated in support of a high performing health plan and ... network. The Clinical Reviewer will investigate quality complaints/grievances and appeals , document research of initial coverage determinations, and lead… more
- Nuvance Health (Danbury, CT)
- …operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff while partnering with local case management ... organizational efficiency, and maximized reimbursement through denial reduction and successful appeals . The *System Care Coordination Leader* will be responsible for… more
- Waverly Health Center (Waverly, IA)
- …on the Iowa Direct Care Worker Registry (Iowa Department of Inspections and Appeals Health Facilities Division). Completion of Nurse Aide II course preferred. ... scope of practice under the direction of a Registered Nurse . MINIMUM QUALIFICATIONS Education, Experience, and Training + Must...preferred. + Must have successfully completed a minimum of Nurse Aide I course and competency exams and be… more
- Houston Methodist (Sugar Land, TX)
- …utilization review activities, and monitoring the clinical denial management and appeals process, as applicable, in collaboration with clinical team partners. This ... and determines the need for or feasibility of submitting appeals . + Facilitates communication with payors and external case...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- Iowa Department of Administrative Services (State Of Iowa, IA)
- …IA Job Type Full-time Job Number 26-00884 Agency 427 Department of Inspections, Appeals & Licensing Opening Date 10/02/2025 Closing Date 10/12/2025 11:59 PM Central ... achievement with a sense of purpose? The Iowa Department of Inspections, Appeals , and Licensing (DIAL) is seeking a highly motivated, flexible, and enthusiastic… more
- City and County of San Francisco (San Francisco, CA)
- …anesthesia; and performs related duties as required. The Certified Registered Nurse Anesthetist (CRNA) requires responsibility for: carrying out established methods ... patient to recovery room and reports condition to receiving nurse . + Maintains an accurate anesthesia narcotic record. The...Rule 111A.35.1. The standard for the review of such appeals is 'abuse of discretion' or 'no rational basis'… more