• Denials Management Specialist…

    St. Luke's University Health Network (Allentown, PA)
    …communities we serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party ... JOB DUTIES AND RESPONSIBILITIES: + Reviews all Inpatient Retroactive Denials in the Denials Management ...monotony. EDUCATION: Graduate of an accredited professional nursing program. Registered nurse with current license to practice… more
    St. Luke's University Health Network (08/19/25)
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  • Senior Denials Mgmt Specialist

    Houston Methodist (Sugar Land, TX)
    At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the ... and denials for no authorization. The Senior Denials Management Specialist position communicates...nongovernmental payers preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (07/31/25)
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  • RN Clinical Denials Appeals…

    CommonSpirit Health Mountain Region (Centennial, CO)
    …who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue management liaison for all care sites with external ... BSN required Minimum Experience required: 4 years clinical experience as a Registered Nurse . 3 years with progressive experience in utilization review,… more
    CommonSpirit Health Mountain Region (09/10/25)
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  • Clinical Denials Specialist

    UHS (Binghamton, NY)
    Position OverviewUnited Health Services (UHS) is seeking a proactive and analytical Clinical Denials Specialist to join our Revenue Cycle team. In this vital ... (5) years of experience in acute/tertiary facility. + Minimum Required: NYS Licensed Registered Nurse Preferred: + Bachelor's of Science in Nursing with three… more
    UHS (09/09/25)
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  • Clinical Denials Coordinator

    UNC Health Care (Goldsboro, NC)
    …Responsibilities: 1. Provides leadership, clinical expertise and organization to the Denials Management Team within the clinical documentation team. 2. ... Minimum 7-10 years of applied clinical experience as a Registered Nurse required. * Minimum 3-5 years...or compliance experience preferred. * Minimum 1 year clinical denials management preferred. Knowledge, Skills and Abilities… more
    UNC Health Care (08/14/25)
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  • DRG Denials Auditor

    Community Health Systems (Franklin, TN)
    …+ CRNP, LPN, RN , MD, PA, or DO preferred + CCS-Certified Coding Specialist required or + RHIT - Registered Health Information Technician required or + ... **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits...Medical Coding Program preferred + Associate Degree Health Information Management or related field preferred + 3-5 years Inpatient… more
    Community Health Systems (09/09/25)
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  • Registered Nurse - Utilization…

    HonorHealth (AZ)
    …experience in UR/UM or Case Management - Required 3 years as a Registered Nurse in an acute care setting - RequiredLicenses and Certifications Registered ... Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care… more
    HonorHealth (08/22/25)
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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 (09/10/25)
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  • DRG Specialist II

    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 II to join our coding team! This... (CCS) OR Certified Professional Coder (CPC) OR Certified Registered Nurse Practitioner OR Doctor of Medicine… more
    UPMC (08/21/25)
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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 (09/10/25)
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