• Registered Nurse Clinical Denials

    Catholic Health (Buffalo, NY)
    …identification of root cause and process improvement opportunities to eliminate recurring clinical denials . The position acts as a liaison between front-end ... areas and third party payers in scenarios related to denials and appeals . This position educates all...(3 ) years of experience monitoring, reviewing and appealing clinical denials or relevant experience preferred +… more
    Catholic Health (04/23/25)
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  • Manager - Utilization Review…

    Beth Israel Lahey Health (Plymouth, MA)
    denials . + Responsible for appeals and follow up on clinical denials escalated through a work queue, providing appropriate response supported by ... people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who...UR and the analysis, resolution, monitoring & reporting of clinical denials . + Maintains current knowledge of… more
    Beth Israel Lahey Health (04/29/25)
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  • Denials Management RN Specialist Remote

    AdventHealth (Altamonte Springs, FL)
    …will contribute:** This position is responsible for investigating and appealing post-remit denials for all Inpatient and Outpatient clinical services across the ... will bring to the team:** + Reviewing and appealing denials for all clinical services across the...problems **Preferred Qualifications:** . Master's Preferred . Certified Case Manager (CCM) Preferred . Certified Clinical Documentation… more
    AdventHealth (05/06/25)
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  • Clinical Appeals Coordinator…

    Penn Medicine (Philadelphia, PA)
    …our future each day. Are you living your life's work? **Summary:** + The Clinical Appeals Coordinator will play an essential role in maximizing collection of ... responsible for management of lists and processes related to denials and appeals .Coordinator also prepares quarterly denial...Nursing and 5+ years Working as a RN Case Manager and /or Appeals Coordinator required. We… more
    Penn Medicine (04/29/25)
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  • CHS Utilization and Appeals Coordinator

    Catholic Health Services (Melville, NY)
    …services and coordinates utilization/ appeals management review. | Assist Utilization and Appeals Manager in setting up communications with payors and/ or ... accurate utilization data in a timely fashion. | Monitors denials as well as all financial metrics associated with...departments. | Develops/validates daily work lists for Utilization and Appeals Manager . | Assist with all insurance… more
    Catholic Health Services (02/14/25)
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  • Manager Collections

    Methodist Health System (Dallas, TX)
    …Of Week :** Mon-Fri **Work Shift :** **Job Description :** Your Job: The Manager of Collections Physician Billing is responsible for overseeing the AR follow up team ... drive performance improvements and meet departmental and organizational goals. The Manager will work closely with various internal and external departments,… more
    Methodist Health System (05/01/25)
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  • Delivery Senior Manager

    NTT America, Inc. (Plano, TX)
    … to join our team. NTT DATA is seeking to hire a **Medicare Appeals Clinical Leader** to lead service delivery engagements and improve end-to-end delivery ... of Medicare Appeals . Desire experience specifically for processes for clinical appeals coordinators but this role will be a leader in the end-to-end delivery… more
    NTT America, Inc. (04/30/25)
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  • Inpatient Clinical & Coding Specialist…

    Independent Health (Buffalo, NY)
    …coding guidelines and financial policies/contracts. + Responsible for all reconsideration clinical appeals to include review of records, consultation with ... Specialist (CCDS), American Health Information Management Association (CCS-H, CCS-P), Certification Denials and Appeals Management (C-DAM), or NYS licensed RN… more
    Independent Health (04/15/25)
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  • Patient Account Representative - Billing & Coding,…

    Surgery Care Affiliates (Boise, ID)
    …Effectively and independently manages second level reimbursement issues, contracted and non-contracted denials and appeals . + This is a demanding environment, ... by working with insurance providers to resolve issues. + Denials and Claims: + Handle denials and...a patient account representative. + High school graduate. Previous clinical , accounts receivable, medical billing appeals and… more
    Surgery Care Affiliates (03/05/25)
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  • Mkt Manager Utilization Mgmt - Texas…

    Catholic Health Initiatives (Houston, TX)
    …processes concurrent denials that require medical necessity determinations; processes appeals and reconsiderations. Act as a working manager within ... **Responsibilities** The Utilization Management (UM) Manager is responsible for managing day-to-day UM operations within the markets, focusing on effective team… more
    Catholic Health Initiatives (05/04/25)
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