• Director Clinical Appeals

    Mayo Clinic (Rochester, MN)
    …through such situations successfully. Travel required as assignments warrant. **Position Overview** The Director of Clinical Appeals will serve as a ... Competitive retirement package to secure your future. **Responsibilities** The Director reports to the Sr. Director Revenue...Clinic enterprise, driving performance, compliance, and outcomes related to clinical denials and appeals . You… more
    Mayo Clinic (08/09/25)
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  • System Director Claim Denials

    SSM Health (MO)
    …or Medical Group revenue cycle areas. The scope of responsibility is all post-billed denials (inclusive of clinical denials ). Engages with key leadership ... improvement. + Oversees communication and follow-up processes related to denials and appeals to ensure such activities are submitted timely, tracked, trended… more
    SSM Health (08/01/25)
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  • Director - Billing Operations…

    Caris Life Sciences (Irving, TX)
    …impact begins.** **Position Summary** Caris Life Sciences is seeking an experienced and strategic Director of Billing Operations - Appeals to lead the appeals ... and genetic testing services. This role is responsible for overseeing appeals processes associated with denials from Caris-contracted and non-contracted… more
    Caris Life Sciences (08/08/25)
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  • RN Clinical Review Appeals

    St. Luke's University Health Network (Allentown, PA)
    …regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data ... needed for workflow or identification of trends. Assists in preparing reports regarding denials to include volumes, number of appeals , case resolution, and… more
    St. Luke's University Health Network (07/08/25)
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  • Appeals Manager

    BronxCare Health System (Bronx, NY)
    …arrive in letter and electronic format. Collaborating with the Department Denial and Appeals Coordinators, Physician Advisors, and the clinical staff, the Appeal ... for the staff on identified deficiencies to best respond to all hospital denials notification and documentation efforts. The Appeals Manager will provide timely… more
    BronxCare Health System (06/21/25)
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  • Data Coordinator, Government Audits…

    Penn Medicine (Bala Cynwyd, PA)
    …provider groups and alternative care settings. Under the direction of the Director of Hospital Compliance, Government Audit and Appeals , receives, reviews, ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
    Penn Medicine (08/07/25)
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  • Medical Director Physician Advisor UM

    AdventHealth (Altamonte Springs, FL)
    …and grievances from patients; assists in drafting and submitting clinical denial appeals , as needed + Develops Medical Director relationships with payors to ... as collaborating with other disciplines to assist in the improvement of clinical documentation, patient safety, and quality outcomes. Through primary support of… more
    AdventHealth (08/07/25)
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  • Director Case Management

    Brockton Hospital (Brockton, MA)
    …external review agencies, to coordinate activities involved in medical record review, denials , appeals and reconsideration hearings. Works closely with the ... PURPOSE OF POSITION: The Director of Case Management is responsible for planning,...the development and supervision of staff (RNs, LPN's,SWs and non- clinical support), evaluation and maintenance of case management skills… more
    Brockton Hospital (06/13/25)
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  • Director Med Staff Services

    HCA Healthcare (Manchester, NH)
    …new medical staff members (in partnership with other key stakeholders to include Director of Advanced Clinical and IT&S personnel). Facilitate orientation for ... We care like family! Jump-start your career as a Director Medical Staff Services today with Catholic Medical Center....play a key role in the integration of HCA Clinical Strategies and HCA systems. **Medical Staff Administration** Develop… more
    HCA Healthcare (06/28/25)
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  • Senior Child Behavioral Medical Director

    Centene Corporation (New York, NY)
    …and coordinate the medical affairs functions for the business unit. Oversee the denials and appeals department. May manage other medical directors. Assume VPMA ... and other ad hoc committees. + May oversee all aspects of the Appeals and Denials department including implementing budgetary, policy, and personnel decisions… more
    Centene Corporation (08/08/25)
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