- Cognizant (Annapolis, MD)
- …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...by performing advanced level work related to clinical denial management and managing clinical denials from Providers… more
- CommonSpirit Health (Centennial, CO)
- …you flourish and leaders who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue management liaison for all care sites ... BSN required Minimum Experience required: 4 years clinical experience as a Registered Nurse . 3 years with progressive experience in utilization review,… more
- AdventHealth (Orlando, FL)
- …medical/hospital nursing experience [Required] + Registered Nurse ( RN ) [Required] **Preferred qualifications:** + Prior Care Management /Utilization ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- AdventHealth (Winter Park, FL)
- …Degree Nursing + Current valid State of Florida or multistate license as a Registered Nurse + 2 years of medical/ hospital nursing experience **Preferred ... transitions, patient satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily with the… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse Case Manager ( RN ) - 2506003132 Description : DMC Detroit Receiving Hospital , Michigan's first Level I Trauma Center, helped pioneer the ... Rosa Parks Geriatric Center of Excellence. Job Summary The RN Case Manager is responsible to facilitate care along... experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
- WMCHealth (Valhalla, NY)
- …2. Identify opportunities to improve reimbursement. 3. Provide direction to the Case Management staff in relation to denials /appeals which includes training and ... insurance and finance into decision making and problem solving regarding denial management . + Explores strategies to reduce Insurance denials , implements them… more
- Datavant (Nashville, TN)
- …Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing for inpatient admission. ... by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal writing… more
- Sutter Health (San Francisco, CA)
- …in nursing, case management or related field preferred. **CERTIFICATION & LICENSURE:** + RN - Registered Nurse of California + CCM - Certified Case Manager ... Pacific Med Center Van Ness **Position Overview:** Coordinates the utilization management , resource management , discharge planning, post-acute care referrals and… more
- Baystate Health (Springfield, MA)
- …- Maximum $96,137.00 - $110,510.00 - $130,728.00 The Hospital Case Manager is a registered nurse responsible for the coordination of clinical care, quality, and ... interventions for patients at risk for readmissions + Manages concurrent denials and works with physicians to overturn for appropriate reimbursement **Required… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for accuracy in ... the denial and appeal status. + Consults with Coordinator and/or Director, Coding Denials and Appeals during any audit discrepancies. + Attends coding education to… more