- Beth Israel Lahey Health (Cambridge, MA)
- …reliability processes to reduce serious safety events and improve patient outcomes. The nurse works with clinical staff to review clinical charts, interpret ... Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported...on the key performance indicators and quality measures, the RN specialist also aims to foster a culture of… more
- University of Michigan (Ann Arbor, MI)
- Utilization Rev Appeals Spec Apply Now **Job Summary** **Why Join Michigan Medicine's Hospital Billing Audits & Appeals (HBAA) Department?** The Audit and ... knowledgeable about insurance requirements and medical billing practices. The Appeals Specialist will collaborate with multiple departments to maintain compliance… more
- BronxCare Health System (Bronx, NY)
- …special projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate ... preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute...submission in appeal. - In absence of Director, will review denial correspondence to determine validity of denial reason… more
- Centene Corporation (Little Rock, AR)
- …practice in Arkansas.** **Position Purpose:** Act as the liaison for all statewide appeals , fair hearings, review organizations, and other external type ... all appeal letters generated comply with both State and NCQA requirements. + Review clinical information for all appeals utilizing nationally recognized criteria… more
- CVS Health (Baton Rouge, LA)
- …benefit plan structure and regulatory requirements are required to support the appeals review . -Pro-actively and consistently applies the regulatory and ... Must reside in Louisiana Responsible for intake, investigation and resolution of appeals , complaints and grievances scenarios for all products, which may contain… more
- Molina Healthcare (Orem, UT)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... Looking for a RN with experience with appeals , claims review , and medical coding. JOB...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- State of Colorado (Pueblo, CO)
- …date and time listed. + Description + Benefits + Questions Department Information Registered Nurse I-Full Time CMHHIP This position has a residency waiver ... Nurse I - RN Critical Incident/Occurrence...in accordance with nursing education and licensure as a Registered Nurse . Duties in this position include:… more
- Hartford HealthCare (Farmington, CT)
- …management and appeals preferred. **Licensure, Certification, Registration** * Active Registered Nurse license from the State of Connecticut * Certified ... Key responsibilities include timely investigation of DRG downgrades, submitting appeals , coordinating follow-up actions and ensuring compliance with regulatory… more
- State of Colorado (Denver, CO)
- Charge Nurse RN II (Internal Pool)- CO Mental...a license. As an example, if you are a registered nurse with a multistate license from Arizona ... Fort Logan (S. Denver) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5125585) Apply Charge Nurse RN II (Internal Pool)- CO Mental Health… more
- State of Colorado (Denver, CO)
- …Health Facilities and Emergency Medical Services Division. and Current, valid licensure as a Registered Nurse from the Colorado Board of Nursing or any state ... RN * Health Compliance Inspector, Acute Care HFEMSD -...closely related field and Current, valid licensure as a Registered Nurse from the Colorado Board of… more