• RN Clinical Review Appeals

    St. Luke's University Health Network (Allentown, PA)
    …we serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… more
    St. Luke's University Health Network (10/28/25)
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  • Appeals & Eligibility Specialist

    State of Indiana (Indianapolis, IN)
    Appeals & Eligibility Specialist Date Posted: Jan 9,...the QMRP requirements at 42 CFR 483.430, or - A registered nurse in Good Standing with the State ... of Indiana plus one year's experience in human services; or- A bachelor's degree in social work, psychology, sociology, counseling, gerontology, or nursing; or health and human services or a bachelor's degree in any field plus a minimum of two years' full-time… more
    State of Indiana (01/09/26)
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  • Clinical Denials Prevention & Appeals

    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 ... notice of conversion, etc. * Tracking and trending all appeals and communicating on a daily/regular basis with the...* Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum of… more
    Nuvance Health (12/25/25)
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  • Appeals Audit Specialist - McLaren…

    McLaren Health Care (Mount Pleasant, MI)
    …of the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer appeal/filing deadlines are met and achieve optimal ... other related duties as required and directed. **Qualifications:** **_Required:_** + Registered Health Information Technician (RHIT), Licensed Practical Nurse more
    McLaren Health Care (11/11/25)
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  • CDOC Registered Nurse ( Nurse

    State of Colorado (CO)
    CDOC Registered Nurse ( Nurse I) Print...RN license. 07 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5123731) Apply  CDOC Registered Nurse ( Nurse I) Salary $7,591.00 - $10,627.00 Monthly… more
    State of Colorado (11/11/25)
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  • Clinical Appeals and Disputes Nurse

    University of Washington (Seattle, WA)
    …changes impacting revenue cycle **REQUIREMENTS** + Active licensure to practice as a Registered Nurse in Washington State + Bachelor's degree in Nursing + ... Medicine's Patient Financial Services Department** has an outstanding opportunity for a **Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + 100% FTE +… more
    University of Washington (12/19/25)
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  • Registered Nurse Care Coordinator-…

    Cedars-Sinai (CA)
    …as a condition of continued employment. **Req ID** : 13443 **Working Title** : Registered Nurse Care Coordinator- Inpatient Specialty Program - 8 Hour Days $5K ... Investigates, processes and assists with the resolution of provider grievances and appeals in accordance with contractual requirements and corporate policy. + Begins… more
    Cedars-Sinai (01/01/26)
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  • Denial RN DRG Appeal Writer1 / HIM Coding

    Hartford HealthCare (Farmington, CT)
    …management and appeals preferred. **Licensure, Certification, Registration** * Active Registered Nurse license from the State of Connecticut * Certified ... and other common practices across the system. *_Position Summary:_* The Denial Specialist is responsible for reviewing, analyzing and appealing denials related to… more
    Hartford HealthCare (11/26/25)
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  • Senior Denials Mgmt Specialist

    Houston Methodist (Sugar Land, TX)
    …of care for government and nongovernmental payers preferred **LICENSES AND CERTIFICATIONS** **Required** + RN - Registered Nurse - Texas State Licensure - ... At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical… more
    Houston Methodist (01/10/26)
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  • Pediatrics Clinical Nurse Specialist

    City and County of San Francisco (San Francisco, CA)
    …and Certification: + Registered Nurse License: Possession of a valid California Registered Nurse ( RN ) license issued by the California Board of ... Registered Nursing; AND + Clinical Nurse Specialist Certificate: Possession of a valid... Specialist Certification: The clinical nurse specialist is a BRN certified RN who… more
    City and County of San Francisco (01/10/26)
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