• Staff Nurse - Utilization Review (Float)

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a*Staff Nurse *to join our Utilization Management department in a*/*FLOAT*/*/assignment to support Inpatient, Psych and the ... Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating the medical necessity, appropriateness,… more
    Minnesota Visiting Nurse Agency (10/02/25)
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  • Clinical Documentation Integrity Manager-…

    Garnet Health (Middletown, NY)
    …Garnet Health Medical Center. Responsibilities Under the direction of The Administrator, Coding & Clinical Documentation Improvement and Patient Access, the ... knowledge, required* Exceptional ability to communicate effectively with physicians and other clinical professional staff.* Knowledge of DRG and Coding appeal… more
    Garnet Health (09/05/25)
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  • AVP Care Coordination

    Nuvance Health (Danbury, CT)
    …and operational oversight for a team of utilization review staff, denials and appeals specialists, non- clinical support staff while partnering with local case ... appeals specialists to meticulously investigate denied claims, prepare comprehensive appeals , and collaborate with clinical staff to ensure successful… more
    Nuvance Health (09/10/25)
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  • Patient Accounts Coder

    Peak Vista (Colorado Springs, CO)
    …for understanding clinical documentation and how it relates to medical coding , coding guidelines and payer rules. Essential Duties and Responsibilities ... exceptional health care to people facing access barriers through clinical programs and education. We provide integrated health care...+ Provides expertise to Accounts Receivable Staff in addressing appeals for denials due to potential coding more
    Peak Vista (10/14/25)
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  • Supervisor, Payment Integrity

    Centene Corporation (Jefferson City, MO)
    …a fresh perspective on workplace flexibility. **Position Purpose:** Responsible for leading clinical coding compliance nurses and non- clinical team members ... indicators + Identifies and implements best practices and operational efficiencies + Researches clinical and coding questions and issues + Triages and resolves… more
    Centene Corporation (09/27/25)
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  • Mental Health Clinician III (Staffing Office)…

    State of Colorado (Denver, CO)
    …Ensures equipment and supplies dispensed from department office are charged to appropriate coding string(s). The Clinical MHC III will be responsible for the ... and inclusion + Strong family and community partnerships The Clinical Mental Health Clinician III works in the 24-hour...member who operates under the supervision of a licensed nurse within Nursing Services. This position is generally responsible… more
    State of Colorado (10/14/25)
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  • Regional Manager Denial Management - McLaren…

    McLaren Health Care (Grand Blanc, MI)
    …trends and direction to assist front-end processes such as utilization management, clinical documentation improvement, coding , and billing etc. to reduce ... of Medicine Degree **.** **4 years of utilization management, case management, clinical documentation, and/or denials/ appeals experience in an acute healthcare… more
    McLaren Health Care (09/26/25)
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  • Utilization Management Manager (Hybrid)

    CareFirst (Baltimore, MD)
    …authorization of services and approved claims. + Prepares retrospective reviews, case appeals , billing coordination, and clinical support. + Manages the analysis ... hiring methods to meet departmental needs. We are looking for an experienced clinical leader in the greater Baltimore metropolitan area who is willing and able… more
    CareFirst (10/11/25)
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  • RN - MDS Coordinator

    Elderwood (Cheektowaga, NY)
    Salary $38 - $49.50 per hour Overview Are you a Registered Nurse (RN) with Medicare experience? Do you consider yourself an expert in assessment and reimbursement ... of Benefits Program + Increased Tuition Reimbursement Program for Clinical Tracks + Shift Differentials + Full Benefits Package...for pre and post-pay record reviews, ADR requests and appeals processes. + Manages NYS RUGs III case mix… more
    Elderwood (10/04/25)
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