Remote RN: Clinical Denials & Utilization Coordinator
Jackson Health System
- Remote job
Jackson Health System in Miami, FL seeks a Clinical Denials Coordinator to support the Utilization Review team within Revenue Cycle. Responsibilities include reviewing denied accounts, identifying trends, and leading efforts to improve recovery outcomes across Emergency Dept and Inpatient UR workflows. The role requires 3–5 years of related experience, RN background (ED/ICU/IR/OR preferred), InterQual review experience, and a Bachelor's in Science. #J-18808-Ljbffr Jackson Health System
- ...no weekendsEducation and Experience:RHIT, RHIA, or related coding certification required.Minimum 3-5 years of clinical experience preferred.Previous utilization management or case management experience preferred.Certifications/Licensures Required:RHIT, RHIA, or related...Remote workFull timeMonday to Friday
- ...Clinical Denial Management NurseTurn clinical expertise into stronger appeals... ...the enterprise.Work Style: Remote Location Requirement: Must... ...revenue integrity, managed care, utilization review, and patient access.... ...nursing as a Registered Nurse (RN) or Licensed Practical Nurse...Remote workFull timeWork at office
- ...Clinical Denials Coordinator Facility Name: Jackson Health System - Clinical Denial... ...FL 33136 Shift Details: Remote - Per Diem Days 8:00 am - 4... ...coverage within the entire Utilization Review team within Revenue... ...in Nursing. Valid RN is preferred. Jackson Health...Remote workDaily paidShift work
$76k
...NTT DATA is seeking a BPO Clinical Review Specialist in the United States, with remote work available for Florida residents. The role requires an active RN license (Florida or Compact) and at least 3 years of appeals, utilization management, or clinical review experience...Remote work- ...Department: Case Management Remote Monday - Friday 7:30am... ...Network Manager for Utilization Management, assists in... ...of admissions via the clinical review and appeal... ...supports Care Coordination department efforts in... ...initiates concurrent denial documentation and operational...Remote workFull timeWork at officeMonday to FridayShift work
- ...scalable solutions and clinical expertise help solve... ...products and services: Denials Management and Complex... ...position: Location: Remote (Within US Only)... ...supporting documentation, utilization of on-staff clinicians... ...described. Regular eye-hand coordination and manual dexterity...Remote workHourly payFull timeImmediate startMonday to Friday
- ...Description Job Description: Manager of Clinical Utilization Management - Denial Compliance Location: Burbank, CA Position Type: Hybrid (85% remote, 15% onsite in Northridge, CA); Full-... ...Registered Nursing Program; RN preferred. 2. Minimum of five years...Remote workPermanent employmentFull timeTemporary workFlexible hours
$27 - $30 per hour
...awards. Job Summary The Utilization Review Coordinator is responsible for... ...with admissions, counselors, clinical leadership, payers, and other... ...activities. Assists with denial management, appeals, and requests... ...this position is primarily remote unless business needs...Remote work$34 - $35 per hour
...Utilization Management - Clinical Nurse - Work from Home! Utilization Management... ...processing of all denial determinations... ...course and prognosis Coordinate with hospital staff... ...reviews Qualifications RN license in an eNLC (... ...Prior Authorization Remote Registered Nurse (...Remote workFull timeWork at officeWork from homeNight shift- ...join the outpatient Pacemaker/Device Clinic in Illinois. You will provide high-quality... ...devices, performing in-clinic and remote checks, and coordinating with electrophysiologists to optimize... ...The role requires a current Illinois RN license, BLS, and 1-2 years of clinical...Remote work
- Loyola Medicine is seeking a skilled Registered Nurse for our outpatient Pacemaker/Device Clinic. You will perform in-clinic and remote device checks, analyze device data, and collaborate with cardiology teams to optimize device settings while educating patients and families...Remote work
- ## Utilization Management CoordinatorApply: Remote - OK: Part time: Posted Today: JR32024**Current... ...administrative and clinical support to the hospital... ...discharge planning. UM Coordinators participate in treatment... ...insurance companies, when denial of reimbursement is related...Remote workPart timeWork experience placementWork at office
- Shape Healthcare Reimbursement With Your RN Expertise ERISA Recovery is seeking an experienced Registered Nurse (RN) with a strong background in utilization management, clinical review, and denial appeals to join our growing team in Plano. This is an ideal opportunity for...Relocation
$45 - $50 per hour
...looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical... ...nursing programs with an active New York RN license. #J-18808-Ljbffr...Remote jobHourly pay$45 per hour
...Job Description Job Description Utilization Management Nurse Coordinator (RN or LVN) needed for a temp 6+ month, remote contract opportunity with Yoh’s managed care health... ...one weekend per month. Utilize your clinical expertise to support quality, cost-effective...Remote workContract workTemporary workMonday to FridayWeekend work$25 - $30 per hour
Utilization Management Coordinator - Casual# Careers## Utilization Management Coordinator - CasualApply: Remote: Full time: Posted 5 Days Ago: JR100132About Altais... ....* Prepare the denial letters under the supervision... ...telephone for missing clinical documentation necessary...Remote workFull timeCasual workWork at officeLocal areaFlexible hours- ...Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday... ...this role, you will evaluate clinical documentation, assess medical... ..., reconsiderations, and denial management as needed. Compliance...Remote workFull timeMonday to Friday
- ...results. The Opportunity: The RN, Utilization Review performs advanced... ...requirements and optimize clinical documentation for accurate reimbursement... ...issues, reduce denials, and support revenue integrity... ...4 Monster Top Workplace for Remote Work 2024 Great Place to Work...Remote workFull timeLocal area
$68.81k - $120.72k
...manages concurrent and pre-bill denials to prevent loss of... ...collaboration. Ensure requested clinical information is communicated, monitors... ...for in-house patients, utilizing daily commercial authorization... ...Certifications: Registered Nurse (RN) [Required] AND...Remote workFull timeWork experience placementLocal areaShift workWeekend work$97.82k - $132.04k
...in healthcare. The RN, Senior Utilization Review Quality will play... ...and utilization management denials. Coordinate with service line leaders... ...regarding medical necessity, clinical documentation, compliance... ...experiences This is a remote position; however, candidates...Remote workFull timeTemporary workWork at officeLocal area$63.1k - $94.65k
...have current compact RN license, or be... ...Information: Our Utilization Review team provides... .... Utilizes approved clinical review criteria to determine... ...party payers Denial Management Coordinates the P2P process with... ...Required: This is a remote role which requires...Remote workTemporary workPart timeWork at officeLocal areaFlexible hoursShift work$85k
...Health, Inc. (GOBHI) has an immediate opening for a Utilization Management Coordinator. This key position is a remote office position and needs to be located within... ...The Utilization Management Coordinator provides clinical expertise in mental health and substance use...Remote workFull timeContract workTemporary workFor contractorsWork at officeImmediate startFlexible hours$82.68k - $96.46k
...about this role: The Clinical Guide Part A will be part of the Utilization Management team, responsible... ...This is a full-time, remote position working five 8-... ...clinical summaries and coordinate peer-to-peer (P2P) discussions... ...: ~ Unrestricted RN license with a minimum...Remote workFull timeContract workInternshipMonday to Friday- ...To support clinical staff in a team environment, the full-time Utilization Review Coordinator will manage utilization review requests, verify and enter data into relevant... ...systems, and respond to inquiries while working remotely. Key responsibilities Accesses, triages,...Remote workFull timeWork at office
$18 - $20 per hour
...Utilization Review Coordinator PRIMARY PURPOSE: To assign utilization review requests; to verify and enter data in appropriate system(s); and to provide general support to clinical staff in a team environment. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic...Remote workWork at officeLocal areaFlexible hours$41.6k - $49.92k
...billing processes. Working in coordination with the team Lead, the... ...environment. This position is a remote role with the ability to sit... ...interacting with insurance plans, clinics, patients, and team members... ..., processes, and policies Utilize all available job aids, websites...Remote workHourly payFull timeTemporary workWork at officeLocal area$81.95k - $110.24k
...healthcare. The Lead Utilization Review RN is a key contributor to... ...financial, quality, and clinical performance of the organization... ...to third party payers. DENIAL MANAGEMENT: Coordinates the appeal process with... ...required #LI-LS1 #LI-REMOTE Join an award-winning...Remote workFull timeWork at officeLocal area$40k - $52.3k
...caring community Humana is seeking a Utilization Management (UM) Coordinator to join the Wisconsin Medicaid... ...Administrative Supervisor, you will provide non-clinical support for the policies and... ...Home. Home workstyle is defined as remote but will use Humana office space on...Remote workWeekly payFull timeTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday- ...effective collaboration with diverse clinical teams to maintain patient... ...RESPONSIBILITIES Coordinate all aspects of patient care for... ...required 10% Simultaneously utilize several software platforms and... ...Roon ~ Current State of PA RN licensure OR Current multi-state...For contractorsLocal areaRelocation package
- ...growing healthcare team, the full-time Utilization Management Coordinator will manage member support, prior... ...administrative case management tasks in a fully remote environment. Key responsibilities... ...cases to completion, escalating clinical concerns as necessary Required...Remote workFull timeWork at office
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