- CommonSpirit Health (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
- 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, ... Nights available* *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
- McLaren Health Care (Grand Blanc, MI)
- …of the patient care team. Educates health team colleagues about complex clinical appeals / denials , utilization review, including role, responsibilities tools, ... and methodologies. _Required:_ + State licensure as a Registered Nurse ( RN ) + Bachelor's...documentation, or utilization review experience + Five years of clinical nurse experience in an acute care… 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 preferred ... Revenue Cycle Denials Management Department by managing and resolving clinical appeals related to government audits and denials . This position requires… more
- Highmark Health (Monroeville, PA)
- …all regulatory and contractual requirements. + Documents, monitors, intervenes/resolves and reports clinical denials / appeals and retrospective payer audit ... across the organization in a community setting. **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
- McLaren Health Care (Mount Pleasant, MI)
- …of the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer appeal/filing deadlines are met and ... education sessions to maintain competency and knowledge of regulations in denials , utilization management, care management, clinical documentation, 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
- Children's Mercy Kansas City (Kansas City, MO)
- …necessity review functions utilizing InterQual and/or MCG screening guidelines, and clinical denials / appeals oversight. Participates in department and ... experience + Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire + One… more
- Avera (Sioux Falls, SD)
- …care payer admission/concurrent level of care denials . + Collaborates with the Clinical Appeals Specialist to ensure tracking and trending of all Utilization ... Review related denials / appeals are appropriately documented. + Assists with...the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse ( RN ) - Board… more