• RN Clinical Review Appeals

    St. Luke's University Health Network (Allentown, PA)
    …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims ... 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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  • Clinical Denials Prevention…

    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 ... in preventing payment denials by providing timely and accurate clinical information to all payers, while ensuring compliance with...notice of conversion, etc. * Tracking and trending all appeals and communicating on a daily/regular basis with the… more
    Nuvance Health (12/25/25)
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  • RN Clinical Appeals

    Molina Healthcare (WI)
    JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals ... health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
    Molina Healthcare (01/02/26)
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  • Appeals Audit Specialist - McLaren…

    McLaren Health Care (Mount Pleasant, MI)
    …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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  • Clinical Appeals and Disputes…

    University of Washington (Seattle, WA)
    …**UW Medicine's Patient Financial Services Department** has an outstanding opportunity for a ** Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + ... FTE + 100% Remote + Days **POSITION HIGHLIGHTS** The Clinical Appeals and Disputes Nurse ...cycle **REQUIREMENTS** + Active licensure to practice as a Registered Nurse in Washington State + Bachelor's… more
    University of Washington (12/19/25)
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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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  • 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 ... care. Use Milliman and Interqual guidelines as necessary. + Collaborates with clinical teams and practices to ensure synchronization of sub-areas' operations to… more
    Cedars-Sinai (01/01/26)
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  • PRN Clinical Utilization Review…

    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 Remote PRN Clinical Utilization Review Specialist is responsible...conducts admission and continued stay reviews, supports denials and appeals activities, and collaborates with healthcare providers to facilitate… more
    Community Health Systems (12/03/25)
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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 submit appeals for DRG denials, ensuring appeals are well-supported with clinical evidence, coding... Clinical Documentation Specialist (CCDS), Certified Documentation Integrity… more
    Hartford HealthCare (11/26/25)
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  • Clinical Documentation Improvement…

    University of Southern California (Arcadia, CA)
    …requirements impact DRG assignments. + Minimum of three years' experience in clinical disciplines ( RN , MD, FMG) or utilization review/case management in ... Documentation Improvement Practitioner (CDIP) certification status preferred. + Certified Clinical Documentation Specialist (CCDS) credential preferred. Pay… more
    University of Southern California (11/24/25)
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