- McLaren Health Care (Grand Blanc, MI)
- …duties as required and directed. **Qualifications:** _Required_ + State licensure as a registered nurse (RN) + Bachelor's degree in nursing from accredited ... with physicians, other team members, payers, and administrators regarding denial and appeals cases reviews and process....or utilization review experience + Five years of clinical nurse experience in an acute care setting + American… more
- McLaren Health Care (Mount Clemens, MI)
- …auditors . Provides support to both internal and external customers for denial / appeals activities and audits. Assists with monitoring and auditing activities, ... requests for medical record documentation and the filing of responses and appeals . 1. Appropriately documents denial /appeal activities; oversees and documents… more
- BronxCare Health System (Bronx, NY)
- …special projects and committees as determined by Director. Qualifications CERTIFICATION/LICENSURE : Registered Nurse or physician or a foreign medical graduate ... the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to… more
- McLaren Health Care (Grand Blanc, MI)
- …**_Required:_** + Associate's degree in nursing or healthcare related field **.** Current Registered Nurse license in the state of Michigan or possess a ... practice standards. 5. Assists with managing the revenue cycle by reducing clinical denial write offs 6. Assists in running reports and utilizes tools for reporting… more
- Beth Israel Lahey Health (Plymouth, MA)
- …+ Collaborates with the multidisciplinary team to assess and improve the denial management, documentation, and appeals process. + Collaborates with UR ... Manager and/or physician advisor regarding cases that do not meet established guidelines for admission or continued stay. + Acts as a liaison between physicians and payers, coordinating peer-to-peer phone calls. + Collects and compiles data as required. _It is… more
- Molina Healthcare (Warren, MI)
- …will work on set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. **Job Summary** Utilizing clinical knowledge and ... and audit details in the database + Provides supporting documentation for denial and modification of payment decisions + Independently re-evaluates medical claims… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- …duties as assigned. + LICENSES AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid Compact ... + GENERAL SUMMARY + The Revenue Integrity Nurse Auditor is responsible for the auditing and...supporting documentation, as well as facilitates the completion of appeals in a timely manner. + Prepares trend and… more
- Houston Methodist (Sugar Land, TX)
- …and nongovernmental payers preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure - Must ... is responsible for performing utilization review activities, and monitoring the clinical denial management and appeals process, as applicable, in collaboration… more
- Nuvance Health (Danbury, CT)
- …in nursing, health administration, or a related field preferred * Current licensure as a registered nurse (RN) * Minimum of 5 years of clinical experience in an ... lengths of stay, enhanced organizational efficiency, and maximized reimbursement through denial reduction and successful appeals . The *System Care Coordination… more
- Arnot Health (Elmira, NY)
- …denial errors, types and recurring issues. 4. Facilitates, coordinates and prepares denial appeals working with internal and external customers in a proactive ... Auth/ Denial Management meetings EDUCATION: RN required. EXPERIENCE: NYS licensed Registered Nurse required. Bachelor's in nursing preferred. Must have… more
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