- Hartford HealthCare (Farmington, CT)
- …Business Office in Newington. *_Position Summary:_* The Revenue Integrity Specialist determines the appropriateness of patient charges, and Charge Description ... and completeness, following regulatory requirements, in order to resolve edits, denials or exceptions detected during system processing of the claim. *_Position… more
- Carle Health (Champaign, IL)
- …Administrator (RHIA) - American Health Information Management Association (AHIMA); Licensed Registered Professional Nurse ( RN ) - Illinois Department ... peers and providers we needed or requested. Reviews DRG denials and provides information to the denials ...DRG denials and provides information to the denials team related to appealing the encounter Qualifications Certifications:… more
- Henry Ford Health System (Troy, MI)
- …SUMMARY: Reporting to the Manager, Revenue Integrity, the Revenue Integrity Specialist identifies revenue opportunities and works collaboratively with Revenue Cycle ... workflows. Primary areas of focus include revenue capture accuracy, decreased denials utilizing standard optimized workflow, and reducing organization risk by… more
- UnityPoint Health (Cedar Rapids, IA)
- …S + Shift: 0900-1700 + Job ID: 174223 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in ... care, optimal clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for patients admitted to BH… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible for ... information and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff, admissions, medical providers, and third-party… more
- CaroMont Health (Gastonia, NC)
- …physicians regarding utilization issues. Collaborates with discharge planning specialist and other disciplines. Retrospectively reviews discharged medical record ... management as necessary. Retrospectively reviews medical record for clinical denials . Composes a detailed summary of care and sends...clinical reviews/appeals as part of denial process. The UR Specialist will be cross trained to work for the… more
- AnMed Health (Anderson, SC)
- …+ Initiates peer-to-peer ie MD to MD calls with payer physician to avoid denials . Qualifications + Minimum of two years of clinical experience required with current ... SC license as RN . + Bachelor of Science in nursing. + Excellent communication skills, written and verbal. + Excellent communication skills and computer experience +… more
- Trinity Health (Livonia, MI)
- …or Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... within their region. Provides direct oversight of the Clinical Documentation Specialist and Clinical Documentation Integrity Coordinator. Working with the Regional… more
- AdventHealth (Tampa, FL)
- …you'll need to succeed:** Associate's of Nursing Required. 1 years Related Experience Required Registered Nurse ( RN ) current FL Required CCDS - Certified ... **ue you'll bring to the team:** Ensures competency of Clinical Documentation Specialist staff by conducting on-going reviews and skills assessments; provides action… more
- Rochester Regional Health (Rochester, NY)
- …experience preferred. + Experience with EPIC preferred. EDUCATION: BS LICENSES / CERTIFICATIONS: RN - Registered Nurse - New York State Education ... in various system committees and work groups, including billing, revenue cycle, denials , and others as assigned. + Ensure effective staffing levels by evaluating… more