- Nuvance Health (Danbury, CT)
- *Description* *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within the first 12-24 hours ... in preventing payment denials by providing timely and accurate clinical information to all payers, while ensuring compliance with...notice of conversion, etc. * Tracking and trending all appeals and communicating on a daily/regular basis with the… more
- Mount Sinai Health System (New York, NY)
- …(CCM, ACM) or Utilization Management preferred. + 7+ years of experience in clinical acute clinical , utilization management, appeals management or related ... + Ensure timely and appropriate communication with payers for authorization, denials, and appeals . + Collaborate with physicians and clinical teams to ensure… more
- Evolent (Springfield, IL)
- …to Standard processing, documenting accordingly. + Works closely with the appeals -dedicated Clinical Reviewers to ensure timely adjudication of processed ... for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
- Catholic Health (Buffalo, NY)
- …is vital. Responsibilities: EDUCATION + Bachelor of Science Nursing (BSN) degree + Registered Nurse with a current New York State license CERTIFICATION + ... mentoring Utilization Review, Clinical Documentation Integrity and Clinical Denials and Appeals teams. They ensure...payers strongly preferred + Must maintain New York State RN license EXPERIENCE + Minimum of eight (8) years… more
- Corewell Health (Royal Oak, MI)
- …experience in care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon ... criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization… more
- State of Colorado (Denver, CO)
- …(HP III RN ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5183355) Apply Registered Nurse , Health Compliance Inspector Home Care - ... health, safety, and well-being of Colorado communities. As a Registered Nurse ( RN ) Health Professional...such as location and availability Essential Competencies (Required) + RN clinical judgment in the field: Applies… more
- Corewell Health (Dearborn, MI)
- …experience in care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire ... criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization… more
- State of Colorado (Golden, CO)
- Registered Nurse I, RN I - Campus at Lookout Mountain, Youth Services Center - Golden Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5185059) Apply Registered Nurse I, RN I - Campus at Lookout Mountain, Youth Services Center… more
- Rochester Regional Health (Rochester, NY)
- …BLS - Basic Life Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education Department ... Job Title: Registered Nurse I Department: Utilization Management...UM review findings, initiate and 1st, 2nd, and/or arbitration appeals as needed. Document in all areas that an… more
- Highmark Health (Monroeville, PA)
- …also building relationships across the organization in a community setting. **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care ... and contractual requirements. + Documents, monitors, intervenes/resolves and reports clinical denials/ appeals and retrospective payer audit denials.… more