RN Utilization Review & Denial Specialist (Hybrid)
Surgery Partners
A healthcare organization in Texas is seeking an RN Utilization Review Coordinator to perform utilization reviews and ensure medical necessity compliance. The role involves collaborating with healthcare teams, managing denial appeals, and supporting discharge planning. Candidates should possess a Bachelor's in Nursing and an active Texas RN license along with at least five years of relevant experience. This full-time hybrid position emphasizes attention to detail and critical thinking skills. #J-18808-Ljbffr
- ...RN Utilization Review Coordinator, Full-time Job Category: Managed Care Requisition Number: RNMAN035973 Full-Time On-site Methodist Hospital... ...supports accurate admission status determinations, active denial management, and collaboration with physicians, case managers...SuggestedFull timeLocal areaShift work
- Atlantic Group is seeking an Accounts Receivable Specialist (Temporary) in Plano, TX, to support healthcare revenue cycle operations. This hybrid role involves managing denial management, claims resolution, and accounts receivable recovery. The ideal candidate should have...SuggestedTemporary work
- ...MedStaffing is seeking an Accounts Receivable Specialist (Temporary) in Plano, TX, to support... ...operations. This role involves managing denial resolution, claims follow-up, and... ...work in a fast-paced environment with a hybrid schedule from Monday to Friday. #J-1880...SuggestedPermanent employmentTemporary workMonday to Friday
- A healthcare institution in Addison, TX seeks an experienced Registered Nurse (RN) to oversee the Case Management team focusing on Utilization Review. Responsibilities include managing departmental operations, ensuring compliance with regulations, and improving care coordination...SuggestedFull time
$54.38k
...USA Sr. Specialist, Pricing (Hybrid Role) Country: United States of America It Starts Here:... ...based on multiple data resource. Utilize data mining and data analysis to develop... ...Sets up frequent multi-organizational reviews of key metrics and develop root causes...SuggestedHourly payFull timeContract workWork experience placementShift work- ...seeking a Certified Medical Coding Specialist to focus on surgical services... ...coding and documentation review, ensuring compliance with... ...auditing coding accuracy, analyzing denials, and collaborating with... ...skills. The position offers a hybrid schedule, working three days...Work at office
- ...Job Summary Conduct medical certification review for medical necessity for acute care... ...related to admission qualifications, resource utilization, national and local coverage... ...program and holds an active unrestricted RN license in the State of Texas Experience...Daily paidFull timeReliefWork at officeLocal areaMonday to FridayNight shift
$23 per hour
...join our amazing team and work a hybrid schedule! The Loss Mitigation Specialist will be responsible for educating... ...documents. Communicate approval or denial of a loss mitigation workout option... ...regarding account information. Reviews borrowers’ financial hardship documentation...Hourly payTemporary work- ...seeks a qualified medical certification professional to conduct reviews for medical necessity. The role demands extensive nursing... ...based guidelines. You'll support both acute care and resource utilization, offering a unique opportunity to grow within a renowned healthcare...Relief
- Requirement: Must be a LVN or RN with prior MDS... ...experience with appeals, denials, and audits preferred.... ...Worth area as this is a Hybrid position based out of our... ...Appeals & Revenue Specialist Responsible for managing... ...letters and medical records, reviewing clinical documentation...Work at officeLocal area
- OrthoMed Anesthesia in Addison, TX seeks a Healthcare Claims Denial Management Specialist to identify, analyze, and resolve denied or underpaid medical claims. Responsibilities include reviewing claims, communicating with insurance, and ensuring compliance with regulations...
- ...experience and 2 years of ECMO specialist experience ~... ...(CCRN) CERT CRITICAL CARE RN (E-AEC) ELSO Adult ECMO Practitioner... ...needs and expectations and utilizes these in conjunction with the... ...family participation in care. Reviews personalized patient plan of...Hourly payFull timeShift workNight shift
- A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing...Full timeRemote work
- ...Description - Coding Specialist III (250000US) UT Southwestern... ...accurate and timely review of complex coding and... ...of UTSW accounts utilizing ICD-10-CM, HCPCS, and... ...edits and back-end coding denials Maintains a thorough... ...multiple specialties in a hybrid role as needed....Full timeLive inRemote workWork from homeMonday to FridayFlexible hoursShift work
- ...UT Southwestern Medical Center in Dallas is hiring a Technical Denials Management Specialist II within the Revenue Cycle Department. This role involves reviewing, researching, and resolving insurance claim denials to maximize collections. The ideal candidate should have...Remote work
- ...Services in Dallas is seeking a Coding Specialist focused on surgical services. This role... ...accurate medical coding and documentation review to ensure compliance with payer guidelines... ...certifications. The position offers a hybrid work model and requires high attention to...Remote job
- ...Responsible for the maintaining the knowledge and skill set related to utilization review, care coordination, performance improvement and professional... .../Registration/Licensure Must have current, valid RN license or temporary RN license from the Texas Board of Nursing...Temporary workReliefRemote workShift work
- ...Senior Hospice Revenue Cycle Specialist Location: Addison, TX Job Id... ...accounts, and working denials to resolution. You'll use your... ...palliative care organizations utilizing the Curantis platform—managing... ...Payment Processing Create, review, and submit accurate hospice...Work experience placementWork at officeRemote workFlexible hoursShift work
- ...detail‑oriented and organized Eligibility Specialist to support employee benefits eligibility... ...Work Arrangement: This is a full‑time hybrid position working in our office located in... ..., carriers, and vendor platforms. Review and reconcile carrier invoices, identify...Full timeTemporary workWork at officeLocal areaFlexible hours
- Oms Medical Billing in Addison, TX is hiring an Appeals Specialist. This full-time position requires on-site presence during regular business hours at our corporate office. The ideal candidate will review denied claims, prepare and submit appeal letters, and communicate...Full timeWork at office
$30 - $33 per hour
The Judge Group is seeking an A/R Specialist to manage backlog claims and assigned inventory in Dallas, Texas. The ideal... ...orthopedic and spine claims. Responsibilities include reviewing claims, researching denials, and collaborating with vendors for timely resolution....- ...Management Associate - Dallas or Atlanta (Hybrid) Job Category: Asset Management... ...include analyzing supply and demand trends, reviewing comparable properties, setting optimization... ...regular pricing calls with all properties utilizing the revenue management software....Full timeTemporary workWork at officeLocal areaFlexible hours
- ...Innovations (BI) in Addison, TX, seeks an experienced AP Accounting Specialist to manage high-volume invoice processing. You will own full-... ...making a difference in the lives of children with autism, with hybrid work options and competitive benefits. #J-18808-Ljbffr...
$14.9 - $29.06 per hour
...support for claims activities including reviewing and resolving member and provider complaints... ...(CMS). Responsibilities Enters denials and requests for appeals into... ...further review. Researches claims issues utilizing systems and other available resources....Hourly payWork experience placementWork at officeRemote workWeekend work$90k - $100k
...from Principle Services, LLC Field Safety Specialist We are seeking a highly skilled and... ...operations, specifically within the Electric Utility Industry on Substation and Transmission... ...Support the development and review of safety plans, wire-pulling plans, site...Contract workFor contractorsWork at officeLocal areaRemote workFlexible hours- Financial Additions is in search of an Accounting Specialist based in Addison, Texas. This hybrid role demands a solid background in accounts payable and accounts receivable with experience coding and processing a high volume of invoices weekly. Qualified candidates will...
- BDR Enablement Specialist - Hybrid 3x/Week DFW at Birdeye in Dallas, TX, United States Sales Full‑time About Birdeye Birdeye is the leading... ...agents that execute work at the location level — responding to reviews, updating listings, publishing content, and driving...Full timeWork at officeRemote workWork from homeMonday to FridayFlexible hours3 days per week
$86.8k - $165.2k
...Mobility Payroll and Tax Team as a Principal Specialist, Payroll. The successful candidate will... ...relating to compensation history. Review and respond to information requests from... ...adult backup care. Work Location This is a hybrid role, eligible candidates must reside...Contract workTemporary workWork experience placementWork at officeRemote workWorldwideFlexible hours$82k - $164k
...Principal Specialist, Fp&A The RTX Enterprise Services Strategic Affordability Analysis... ...and reasonable price recommendation to be utilized for supplier and customer negotiations... ...Apply Now! Work Location This is a hybrid role, eligible candidates must reside within...Temporary workWork experience placementRelocationFlexible hours- ...Technical Denials Management Specialist II Our client is seeking a detail-oriented and analytical Technical Denials Management Specialist II... ...Cycle Department. In this role, you will be responsible for reviewing, researching, and resolving claim denials and appeals...Remote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Utilization Review & Denial Specialist (Hybrid). Be the first to apply!
- temporary rn Addison, TX
- operating room travel rn Addison, TX
- neuro icu registered nurse Addison, TX
- endoscopy rn Addison, TX
- public health registered nurse Addison, TX
- clinic registered nurse Addison, TX
- part time registered nurse Addison, TX
- ambulatory care rn - registered nurse Addison, TX
- intensive care unit rn Addison, TX
- dermatology rn Addison, TX

