- Trinity Health (Darby, PA)
- …time Shift: Evening Shift Description: Under the general supervision of the RN Care Coordination Manager and Director of Care Coordination, the Emergency Department ... Also collaborates with Social Work to ensure appropriate primary care and specialist physician follow up. Collaborates with the ED healthcare team to determine… more
- Banner Health (Phoenix, AZ)
- …of prior authorization, census management, prospective/concurrent/retro review, and appeals . Care management: Coordinating/reviewing the work of RNs, navigators, ... require applicable certifications and/or licensures, including but not limited to: RN ; MD or DO; Driver's License; Certified Healthcare Protection Administrator… more
- University of Michigan (Ann Arbor, MI)
- Denials Prevention/ Appeals Specialist Apply Now **Job Summary** The Denials Prevention and Appeals Specialist is responsible for ensuring the accuracy ... employer. **Job Detail** **Job Opening ID** 266022 **Working Title** Denials Prevention/ Appeals Specialist **Job Title** Medical Coder Compliance Spec **Work… more
- 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
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary** Appeals and Grievances Specialist supports the Operations Department and the Appeals and Grievances ... well as externally to facilitate timely resolution of all grievances and appeals and ensures compliance with regulations. Additionally, this position is responsible… more
- LifePoint Health (Hickory, NC)
- * Registered Nurse ( RN ), Clinical Case...the lives of those we serve.** *Connect with our RN recruiting specialist * Not ready to complete an ... valued as an employee, but as a person. As a* registered nurse ( RN )*joining our team,...payer guidelines and discharge financial implications. * Manages denial appeals and chart audit reviews. *7. Case Management** Acts… more
- Molina Healthcare (Midvale, UT)
- **JOB DESCRIPTION** _For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state of UTAH or have a compact license._ _This ... appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of… more
- 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/4963973) Apply CDOC Registered Nurse ( Nurse I) Salary $7,591.00 - $10,627.00 Monthly… more
- State of Colorado (Sterling, CO)
- CDOC Registered Nurse - Part-time - Sterling Print...Yes + No 06 Do you possess an active RN license issued by an Enhanced Nurse Licensure ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4992041) Apply CDOC Registered Nurse - Part-time - Sterling Salary...Colorado? If so, what state issued your license? 07 Nurse Licensure Compact: If appointed to an RN… more
- Commonwealth Care Alliance (Boston, MA)
- 011540 CCA- Appeals & Grievances **Position Summary:** Appeals and Grievances Program Advisor monitors and supports the operations and compliance of the ... Appeals and Grievances department through many NCQA and other...+ Communicate and work collaboratively with AG Representatives, Resolution Specialist and Management to maintain and improve quality of… more
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