- CenterWell (Honolulu, HI)
- …a part of our caring community and help us put health first** The ** Denials Management Specialist** is responsible to respond to, monitor and analyze all ... and monitoring all payer requests for additional documentation (ADR), appeals and denials . Works with branch staff...your skills to make an impact** **Required Experience/Skills:** + Registered Nurse or Physical Therapist. + Current… more
- Beth Israel Lahey Health (Plymouth, MA)
- …making a difference in people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth ... Community!** **In your role as a Utilization Review & Denials Management Manager, you will:** + Directs...Reviews and determines appropriate strategy in response to reimbursement denials . + Responsible for appeals and follow… more
- Houston Methodist (Sugar Land, TX)
- …care for government and nongovernmental payers preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- ... At Houston Methodist, the Senior Denials Management Specialist position is responsible...performing utilization review activities, and monitoring the clinical denial management and appeals process, as applicable, in… more
- Nuvance Health (Danbury, CT)
- …to ensure smooth transitions of care, prevent readmissions, and optimize patient outcomes. * * Denials Management & Appeals :* * *Root Cause Analysis:* Lead a ... strategy for system-wide care coordination, encompassing utilization review (UR), denials management , discharge planning, social work, and...a related field preferred * Current licensure as a registered nurse ( RN ) * Minimum… more
- Rochester Regional Health (Rochester, NY)
- Job Title: Registered Nurse IDepartment: Utilization Management Location: Rochester General Hospital Hours Per Week: 40 hours (Full-Time)Schedule: Monday - ... necessary per UM reviews. + Track and monitor all denials , appeals , arbitration responses to payers/audits. +...- Basic Life Support - American Heart Association (AHA), RN - Registered Nurse -… more
- Hartford HealthCare (Farmington, CT)
- …of education and experience in accordance with job responsibilities *Experience* . Minimum: . Registered Nurse ( RN ) with 5 or more years CDS experience ... (HACs), and other specialty reviews. This position also supports denials and appeals specialists as a subject.... 6 years' experience as a CDS . Previous management experience preferred *Licensure, Certification, Registration* * RN… more
- AdventHealth (Glendale Heights, IL)
- …60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... denials . + Working in collaboration with facility Care Management to ensure that high quality health care services...capacity to prioritize multiple tasks and role components. + Registered Nurse ( RN ) Required +… more
- Brockton Hospital (Brockton, MA)
- …responsibilities. EDUCATION: + RN with Master's Degree + Current License as Registered Nurse in the Commonwealth of Massachusetts EXPOSURE CATEGORY: It is ... PURPOSE OF POSITION: The Director of Case Management is responsible for planning, directing, and managing...agencies, to coordinate activities involved in medical record review, denials , appeals and reconsideration hearings. Works closely… more
- Ascension Health (Wichita, KS)
- …rules and regulations. **Requirements** Licensure / Certification / Registration: + Licensed Registered Nurse credentialed from the Kansas Board of Nursing ... related to coding, medical records/documentation, precertification, reimbursement and claim denials / appeals . + Assess and coordinate discharge planning needs… more
- 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 ... JOB DUTIES AND RESPONSIBILITIES: + Reviews all Inpatient Retroactive Denials in the Denials Management ... and rejections. + Assists in preparing reports regarding denials to include volumes, number of appeals ,… more