• Denials Management Specialist

    St. Luke's University Health Network (Allentown, PA)
    …we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials ... and tracks outcomes regarding appeal process. Assists billing staff regarding outpatient denials for experimental, coding or other issues that may require record… more
    St. Luke's University Health Network (05/14/25)
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  • Denials Prevention/Appeals…

    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 ... opportunity employer. **Job Detail** **Job Opening ID** 266022 **Working Title** Denials Prevention/Appeals Specialist **Job Title** Medical Coder Compliance… more
    University of Michigan (07/11/25)
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  • Registered Nurse RN Case…

    AdventHealth (La Grange, IL)
    …resolution skills . Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** . State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
    AdventHealth (05/31/25)
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  • Registered Nurse RN Care…

    AdventHealth (Hinsdale, IL)
    …for Discharge Planning + Conflict management and resolution skills + Teamwork principles + Registered Nurse ( RN ) Required + Certified Case Manager (CCM) ... 120 N OAK ST, Hinsdale, 60521 **The role youll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians… more
    AdventHealth (07/01/25)
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  • Specialist -Denial II RN

    Baptist Memorial (Memphis, TN)
    Overview Specialist -Denial Mitigation II RN Job Code: 21432 FLSA Status Job Family: FINANCE Job Summary * Position may be filled in Memphis, TN; Jackson , MS The ... Denial Mitigation-Appeal Specialist II RN serves in a key...along to healthcare insurance providers in response to post-claim denials received by BMHCC. Physician Advisor communication may be… more
    Baptist Memorial (07/11/25)
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  • RN Clinical Review Appeals…

    St. Luke's University Health Network (Allentown, PA)
    …Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. . ... a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews...and procedure code assignment and MS-DRG/APR-DRG accuracy based on denials or audit findings from government and commercial payers.… more
    St. Luke's University Health Network (07/08/25)
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  • RN Utilization Review Specialist Per…

    HonorHealth (AZ)
    …1 year experience in UR/UM or Case Management Required Licenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure Required ... more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of...from an accredited NLN/CCNE institution Required Experience 3 years Registered Nurse in an acute care setting.… more
    HonorHealth (06/11/25)
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  • Clinical Authorization Specialist

    Dana-Farber Cancer Institute (Brookline, MA)
    …experience is preferred. + **Certification/Licensure/Registration:** + Licensed as a Registered Nurse in the Commonwealth of Massachusetts preferred. ... molecular pathology, high-cost drug, and off-label drug authorizations. The Clinical Authorization Specialist is also responsible for managing denials related to… more
    Dana-Farber Cancer Institute (07/01/25)
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  • CDI Specialist III

    Covenant Health Inc. (Knoxville, TN)
    Overview Clinical Documentation Integrity Specialist Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's ... be named a Forbes "Best Employer" seven times. Position Summary: The CDI Specialist serves as liaison between the physicians and hospital departments to promote… more
    Covenant Health Inc. (07/02/25)
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  • DRG Specialist

    UPMC (Pittsburgh, PA)
    … Health Information Administrator OR Registered Health Information Technician (RHIT) OR Registered Nurse ( RN ) + Act 34 *Current licensure either in ... UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our... (CCS) OR Certified Professional Coder (CPC) OR Certified Registered Nurse Practitioner OR Doctor of Medicine… more
    UPMC (06/11/25)
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