- CommonSpirit Health Mountain Region (Centennial, CO)
- …with resources to help you flourish and leaders who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue ... Required Education: BSN required Minimum Experience required: 4 years clinical experience as a Registered Nurse...must be in CO, UT, or Kansas.** Must have Clinical Denials experience. Please make sure it's… more
- Catholic Health (Buffalo, NY)
- …8-4 with varied hours based on role of management and oversight of team Summary: The Clinical Denials and Appeals , Clinical Supervisor is responsible for ... include setting up arbitration between parties. This individual provides clinical oversight to the clinical denials...management, operational analysis, information systems or related field + Registered Nurse with a four (4) year… more
- Nuvance Health (Danbury, CT)
- …delays in reimbursement. This role plays a critical part in preventing payment denials by providing timely and accurate clinical information to all payers, ... *Hybrid/Remote* * *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are...initial status is to be re-considered. * Identify incomplete clinical reviews in work queues and complete them within… more
- Cognizant (Washington, DC)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...related to clinical denial management and managing clinical denials from Providers to the Health… more
- Houston Methodist (Sugar Land, TX)
- …care for government and nongovernmental payers preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... billing processes, managed care contracts and coordination of benefits related to coverage, clinical appeals , and denials to include knowledge of CPT and ICD… more
- Stanford Health Care (Palo Alto, CA)
- …Days or + CCDS - Cert Clinical Document Spec required within 180 Days + RN - Registered Nurse - State Licensure And/Or Compact State Licensure required . ... Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials . This position requires… more
- Highmark Health (Pittsburgh, PA)
- …all regulatory and contractual requirements. + Documents, monitors, intervenes/resolves and reports clinical denials / appeals and retrospective payer audit ... :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Registered nurse who is proficient in the...clinical nursing role + Current State of PA RN licensure OR Current multi-state licensure through the enhanced… more
- Charter Care Health Partners (Providence, RI)
- Summary: The Clinical Appeals - Author performs appeals and denials management and represents the hospital where claims were denied by either ... administrative duties as required. Education/Licensure: Medical Graduate, Physician Assistant or Registered Nurse (Current RI License) Experience: + Knowledge of… more
- Nuvance Health (Danbury, CT)
- *Description* *Summary:* The Manager, Denials Prevention & Appeals Operations is responsible for the direct oversight of daily operations of clinical denial ... are approved for medical necessity. This position will work closely with the Denials Prevention & Appeals Administration Manager to guide the development and… more
- WMCHealth (Valhalla, NY)
- Denials and Appeals Mngmt Cord Company: WMC Advanced Physician Services PC City/State: Valhalla, NY Category: Clerical/Administrative Support Department: ... Details: Job Summary: Decrease the monies lost to insurance companies due to denials . Generate appropriate appeals , both retrospective and concurrent, based on… more