- Community Health Systems (Franklin, TN)
- …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating...conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers to facilitate… more
- Monte Nido (Miami, FL)
- …in level of care, discharge, retrospective, facilitating peer to peer reviews, and written appeals . + Engage in clinical rounds as an active treatment team ... team approach while integrating state-of-the-art medical, psychiatric, nutritional, and clinical strategies to provide comprehensive care within an intimate home… more
- UHS (Binghamton, NY)
- …(5) years of experience in acute/tertiary facility. + Minimum Required: NYS Licensed Registered Nurse Preferred: + Bachelor's of Science in Nursing with three ... Position OverviewUnited Health Services (UHS) is seeking a proactive and analytical Clinical Denials Specialist to join our Revenue Cycle team. In this vital role,… more
- Guthrie (Binghamton, NY)
- …to coding, medical records/documentation, precertification, reimbursement and claim denials/ appeals . Assesses and coordinates discharge planning needs with ... Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine. more
- Beth Israel Lahey Health (Plymouth, MA)
- …and determines appropriate strategy in response to reimbursement denials. + Responsible for appeals and follow up on clinical denials escalated through a work ... queue, providing appropriate response supported by clinical information. + Provides oversight of the appeals process and direction regarding appeals and… more
- State of Colorado (Sterling, CO)
- …Rights MINIMUM QUALIFICATIONS: + Applicant must possess a current, valid license as a Registered Nurse from the Colorado Board of Nursing or any state ... III 30492 09/2025 Department Department of Corrections Division Clinical and Correctional Services Opening Date 09/09/2025 Closing Date...years of full-time experience providing patient care as a Registered Nurse . W ork experience less than… more
- State of Colorado (Garfield County, CO)
- …night shifts to include holiday & weekends as needed? + Must possess a valid Registered Nurse License ( RN ) from the Colorado Department of Regulatory ... of Employment & Appeal Rights Education/Licensure/Certification/Experience: Current, valid licensure as a Registered Nurse from the Colorado Board of Nursing or… more
- CareFirst (Baltimore, MD)
- …+ Proficient in Microsoft Office programs. **Licenses/Certifications Required Upon Hire** : Health Services\ RN - Registered Nurse - State Licensure and/or ... authorization of services and approved claims. + Prepares retrospective reviews, case appeals , billing coordination, and clinical support. + Manages the analysis… more
- Sharp HealthCare (San Diego, CA)
- …**Job Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** California Registered Nurse ( RN ) - CA Board of Registered Nursing; ... or equivalent experience in the healthcare setting. + California Registered Nurse ( RN ) - CA...will participate in venues to reduce barriers to discharge.The RN CM I Collaborates with Clinical Resource… more
- Eastern Connecticut Health Network (Vernon, CT)
- …or doctorate degree. + Possession of a current license to practice as a registered nurse or as a physical/occupational therapist in the state of Connecticut. ... Why consider applying to Visiting Nurse & Health Services of CT? Here are...supervises Clinical Documentation Specialists as well as Clinical Support Specialists. EDUCATION/CERTIFICATION: + RN degree… more