- McLaren Health Care (Grand Blanc, MI)
- …communication with related disciplines to address and integrate opportunities for denial appeals . **Essential Functions and Responsibilities as Assigned:** 1. ... Assists in ensuring day-to-day activities of the Denial Appeal department are conducted in an accurate and...tools, and methodologies. _Required:_ + State licensure as a Registered Nurse (RN) + Bachelor's degree in… more
- Molina Healthcare (Salt Lake City, UT)
- **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals ... quality and cost-effective member care. Candidates with UM and Appeals experience are highly preferred Work hours: Monday- Friday...or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active… more
- BronxCare Health System (Bronx, NY)
- …response by the department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager must have excellent verbal ... in letter and electronic format. Collaborating with the Department Denial and Appeals Coordinators, Physician Advisors, and...electronic database system. -The Appeal Manager should be a nurse who has 3-5 years or more of experience… more
- Montrose Memorial Hospital (Montrose, CO)
- …letter writing, eg, appeals , preferred. + Must at least be Licensed as a Registered Nurse in the State of Colorado or possess a Compact State License. + ... to the patient. About The Career: + The Clinical Denial Analyst is a key contributor within the interdisciplinary... Analyst is a key contributor within the interdisciplinary Denial Management Program and is responsible for completing, tracking,… more
- McLaren Health Care (Mount Pleasant, 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
- CommonSpirit Health (Centennial, CO)
- …BSN required Minimum Experience required: 4 years clinical experience as a Registered Nurse . 3 years with progressive experience in utilization review, ... who care about your success. The RN Clinical Denials Appeals Specialist functions as a revenue management liaison for...preferred. Prior experience writing clinical denial appeal letters required. License Required: Curent RN License… more
- Cognizant (Annapolis, MD)
- …Monday to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work ... related to clinical denial management and managing clinical denials from Providers to...to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined… 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 (Buffalo, NY)
- …and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse (RN). License must be active and unrestricted in ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. **Job Summary** Provides support for medical claim… more