Remote RN: Clinical Denials & Utilization Coordinator
Jackson Health System
Miami, FL
- Remote job
Jackson Health System in Miami, FL is seeking a Clinical Denials Coordinator to provide coverage across Utilization Review and Central Clearance workflows. The role supports denial identification, audits, and improvement efforts within the Revenue Cycle, collaborating with payors and denial agencies. The position requires RN licensure with 3–5 years of related experience, plus strong InterQual review familiarity. Remote, full-time daytime schedule available. #J-18808-Ljbffr Jackson Health System
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote RN: Clinical Denials & Utilization Coordinator in Miami, FL vacancy
- ...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
Vivo HealthStaff
Burbank, CA29 days ago - ...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
Populance
Troy, MI2 days ago - ...industry. Overview: The ideal Clinical Reimbursement Specialist... ...perform audits, mentor MDS Coordinators and have TONS of autonomy?... ...PER WEEK WITH ONE DAY WORKING REMOTE** How you Will make a... ...Medicare and Medicare education utilizing various types of media, technology...Remote workMonday to FridayFlexible hoursNight shift
Signature HealthCARE TN, Nashville
Nashville, TN2 days ago - ...Clinical Denial Management Nurse Turn clinical expertise into stronger... ...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
- ...Jackson Health System - Clinical Denial Unit Facility Address:... ...33136 Shift details: Remote - Full Time Days 8:00... ...Summary Clinical Denials Coordinator is responsible for... ...coverage within the entire Utilization Review team within... ...Nursing. Credentials Valid RN is preferred. Jackson...Remote workFull timeShift work
$86.96k - $113.67k
...Utilization Review Nurse Capital Health is the region's leader in providing progressive... ...to third party reimbursement, denials, appeals and clinical audits for inpatient cases. Ensures... ..., care planning, and/or care coordination. Inpatient denial appeal experience...Full timeTemporary workPart timeFlexible hours$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 workYoh, A Day & Zimmermann Company
Redding, CA6 days ago$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... ...of accredited nursing programs with an active New York RN license. #J-18808-LjbffrRemote workHourly paykozmetickesluzby.vecnakraska.sk - Jobboard
United States18 hours ago$20 - $25 per hour
...Management Leadership Location: Remote FLSA Status: Temporary... ...of the Northpoint team, he Utilization Review Coordinator supports Northpoint's... ...tracking, payer correspondence, clinical documentation coordination,... ..., authorization risk, and denial prevention. The UR...Remote workTemporary workMonday to FridayNorthpoint-Recovery-Holdings,-LL
Meridian, ID3 days ago- ...Utilization Management Coordinator This position performs non-clinical functions for the Utilization Management process. Facilitates department workflows by supporting... ...needs. • Provides information required for denial letters for members whose benefits do not cover...Remote work
Saviance
United States2 days ago - Comagine Health is seeking a Clinical Utilization Review Nurse (RN) for a 100% remote, full-time role supporting Alaska contracts. The nurse will assess medical necessity and care quality through prospective, concurrent, and retrospective reviews, applying InterQual criteria...Remote jobFull time
- ...RN Coordinator Utilization Management The RN Coordinator Utilization Management will review submitted... ...Inter-reviewer reliability and denial files) Refer all members with complex... ...required Minimum of four (4) years clinical health care experience as a Registered...Work at officeWork from homeHome officeMonday to FridayWeekend workWeekday work
- ...is seeking a Registered Nurse for a remote role with Arizona hours (1st shift)... ...records for quality, safety, and utilization issues, identify PQIs, and support... ...Medical Directors. Must hold an active RN license, have 3+ years of clinical experience in med/surg or...Remote jobDay shift
$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$78.6k - $102.2k
...Teacher Preparation Programs, the Coordinator of Clinical Fieldwork supports teacher... ...partner in-person and remote meetings. Lead communication... ...technologies are welcome to utilize those services when contacting... ...or genetic characteristics), denial of Family and Medical Care...Remote workFixed term contractLocal area$112.7k - $193.2k
...opportunities with Kelsey-Seybold Clinic, part of the Optum family of... ...recognized for delivering coordinated and accountable care. As a... ...operational oversight for all Utilization Management functions, including... ...Texas Registered Nurse (RN) license or valid multistate...Remote jobMinimum wageFull timeContract workWork experience placementLocal area- ...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
Medix™
New York, NY2 days ago - ...Utilization Management RN There's no place like Liberty Health... ...members and within clinical guidelines Monitor... ...required Assess and coordinate discharge planning... ...and claim denials/appeals. Use critical... ...communicates instructions to remote users. Visit...Remote workWork at office
Liberty Healthcare
Wilmington, NC3 days ago - ...To support clinical staff in a collaborative environment, the full-time Utilization Review Coordinator will assign utilization review requests, verify and enter data into appropriate... ..., and respond to inquiries while working remotely. Key responsibilities Accesses, triages,...Remote workFull timeWork at office
Virtual Vocations Inc
New York, NY4 days ago - ...sites across the U.S. from clinics and hospitals to home-based... ...Responsibilities As our Utilization Review RN, you will meticulously... ...hand-in-hand with Concurrent Denial RNs to identify the root causes... ..., payers, and Care Coordinators-regarding review outcomes....Remote work
Mountain Region Out of State Staffing
United States2 days ago $29.5 - $44.5 per hour
...heartland. Facility: Southridge Clinic Location: Bismarck, ND... ...1 or 2 days a week of remote work depending on the clinic... ...The Registered Nurse (RN) is responsible for utilizing the nursing process (assessment... .... Responsible for the coordination of care, patient assessment...Remote workFull timePart timeWork from homeRelocation packageMonday to FridayShift workDay shift2 days per week1 day per week$25.66 - $28.9 per hour
...billing, bookkeeping, financial spreadsheets, utilization review or other similar electronic... ...confidentiality. Regular attendance is mandatory. Remote / flexible work location eligible up to... ...related to the process for approval/denial of service authorization and payment as...Remote workWork at officeLocal areaFlexible hoursTheuniversityunion
Cuyahoga Falls, OH18 hours ago- ...verification, billing and claims submission, and utilization review, we help treatment centers... ...and managed care companies.Utilize clinical information and knowledge of Medical Necessity... ...at a desk and working on a computer.Remote PositionBenefits:• Competitive salary• Health...Remote workHourly payWork at office
Nrg-Mgmt-LLC
Boca Raton, FL3 days ago $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 hoursSedgwick
United States1 day ago$29.54 - $44.31 per hour
...role and does not offer a hybrid or remote option Summary Facilitates coordination of reimbursement processes for all... ...status, complete reports, denials and notes. Completes initial authorization... .../items needed between payors and clinical team members. Within scope of job,...Remote workTemporary workReliefLocal areaFlexible hoursShift workUC Health
Fort Collins, CO18 hours ago- ...Behavioral Health Utilization Manager Behavioral Health... ...evidenced based clinical criteria, approved medical... ...times. Assists in the coordination of care of... ...appeals standards for denials. Review any requests for... ...systems Work Schedule: Remote Other Requirements: Able...Remote workContract workWork experience placement
Harris Health System
United States1 day ago - ...effective collaboration with diverse clinical teams to maintain patient... ...Responsibilities # Coordinate all aspects of patient care for... ...required. # Simultaneously utilize several software platforms... ...Room ~ Current State of PA RN licensure OR Current multi-state...For contractorsLocal area
Highmark Health
Pittsburgh, PA4 days ago - ...responsible for assisting with the coordination of utilization review, concurrent review... ...five hospitals and eleven clinics provide excellence in our... ...to prepare authorization for RN or MD review. Communicates... ...Workplace Set Up Remote City Murray State...Remote workTemporary workReliefWork at officeMonday to FridayShift work
University of Utah Health
Salt Lake City, UT18 hours ago - ...sites. Job Title: Utilization Review RN Job Summary... ...concurrent, and retrospective clinical reviews to determine... ...care progression, coordinates documentation exchange... ...providers to prevent denials by clarifying documentation... ...Work Conditions ~ Remote role with reliable...Remote workFull timePart timeWork at officeLocal areaWeekend workAfternoon shift
Miami Jewish Health
Miami, FL18 hours ago - ...and geriatrics), GLFHC has clinical sites throughout the service... ...GLFHC is currently seeking an RN Coordinator – Home Visiting Program .... ...high-risk patient tracking. Utilize registries and reporting... ...triage skills and comfort with remote patient management....Remote work
GLFHC
Lawrence, MAa month ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN: Clinical Denials & Utilization Coordinator. Be the first to apply!
