RN Denials & Utilization Review Specialist
UR SOLUTIONS
UR SOLUTIONS is seeking a Denials Management Nurse with a BSN and an active nursing license. The ideal candidate has 5+ years of clinical nursing experience and at least 1 year in utilization review. The role utilizes clinical expertise and insurance knowledge to analyze accounts, medical records, and invoices to pursue retrospective approvals and potential continued access needs. Strong communication and organizational skills are required. #J-18808-Ljbffr UR SOLUTIONS
$18.5 - $26.04 per hour
...General Summary Responsible for supporting the utilization review system including data analysis, report writing, and program improvement. UR Specialist will develop and maintain a VOD Tracking and Receipt system. UR Specialist will maintain an expert level review of client...SuggestedWork experience placement$40.12 - $62.19 per hour
...Utilization Review Nurse RN ~Randallstown, MD ~NORTHWEST HOSPITAL ~NW CARE MANAGEMENT ~Full-time - Day shift - 8:00am-4:30pm ~... ...intervention and coordination to decrease avoidable delays and denial of payment. Interfaces with 3rd party payers by providing...SuggestedFull timeShift workDay shift$40.12 - $62.19 per hour
...Utilization Review Nurse RN ~Baltimore, MD ~SINAI HOSPITAL ~UTILIZATION REVIEW ~Full-time w/Weekend Commitment - Day shift - 8:00... ...stays and referral to the physician advisor as needed Denial Management, including coordination with Case Management...SuggestedFull timeShift workWeekend workDay shift$40.12 - $62.19 per hour
...Utilization Review Nurse RN ~Sign On Bonus Potential: 6,000 ~ Randallstown, MD ~NORTHWEST HOSPITAL ~NW CARE MANAGEMENT ~Part... ...outcomes, efficient utilization of health services and minimize denials of payment among a patient population with complex health...SuggestedPart timeRelocation packageShift workNight shiftWeekend work$1,512 - $1,607 per week
...Registered Nurse (RN) | Utilization Review Location: Baltimore, MD Agency: GQR Healthcare Pay: $1,512 to $1,607 per week Shift Information: Days Contract Duration: 13 Weeks Start Date: ASAP About the Position Contract - W2 Case Management...SuggestedHourly payWeekly payFull timeContract workImmediate startShift work$1,512 - $1,607 per week
...Registered Nurse (RN) | Utilization Review Location: Baltimore, MD Agency: GQR Healthcare Pay: $1,512 to $1,607 per week Shift Information: Days Contract Duration: 13 Weeks Start Date: ASAP About the Position TravelNurseSource is working...Hourly payWeekly payFull timeContract workImmediate startShift work- ...The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost‑effective quality care and cost containment in accordance with various federal and/or state statutes, regulations...Weekly payContract workWork at officeLocal areaRemote work
$81.12k - $115.94k
...**Facility:** Ascension Saint Agnes Hospital **Department:** Utilization Management **Schedule:** Day-Shift | Full-Time **Salary:** $81... ...make an impact in this role** + Advocate for appropriate care by reviewing admissions and service requests to ensure every patient...Full timeLocal areaRemote workDay shift- Aramark at Towson University is seeking a Social Bites General Utility Worker to keep dishes, utensils, and kitchen environments clean and safe, supporting overall foodservice operations. This entry‑level role emphasizes reliability, teamwork, and adherence to safety standards...Flexible hoursAfternoon shift
- ...to practice nursing, three to five years’ experience in clinical nursing, and one year of experience in utilization review. The primary responsibility of the Denials Management Nurse is to utilize clinical expertise, insurance knowledge, business know-how, and high level...Work at office
$46.76 - $51.76 per hour
...supervision of ABA treatment programs. Responsibilities: Reviews ABA treatment requests (initial, concurrent, and retrospective... ...stakeholders. Nice to Have: Prior experience in utilization management, care management, or payer-side review of ABA services...Remote jobWork at office- ...DescriptionPosition Purpose:The Asset Protection Specialist is primarily responsible for preventing... ...assigned store/multiple stores. They utilize tools to minimize loss to the Company,... ...incidents of theft and fraud, reviewing CCTV and exception reports, monitoring the...
$19 - $23 per hour
...Accounts Receivables Specialist Founded 50+ years ago with a mission... ...resolves insurance carrier denials, appealing claims, contacting... ...collection activity performed. Review the account information and... ...Verify claims adjudication utilizing appropriate resources and...Full timeTemporary workRemote work$60.93 per hour
...Job Description ~ The Disaster Program Delivery Specialist: • Collects, coordinates and/or reviews applicant data to determine eligibility and priority... ...documents through FEMA’s Consolidated Resource Centers utilizing a web-based tool, schedules site inspections with...H1bImmediate startFlexible hours$19.31 per hour
...and leisure pursuits that contribute to community integration) utilizing deliberate and consistent skills training which typically includes... ...to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. #J-18...Hourly payPart timeWork experience placementShift workAfternoon shift$51 per hour
...Utilization Management Specialist (UM / Utilization Review Nurse) — Remote Location: 100% Remote (U.S.) — Maryland compact/eligibility required Type: Contract... ...caseload. Required qualifications ~ Active RN or LPN license (RN preferred) — Maryland compact/eligibility...Contract workWork at officeLocal areaRemote workFlexible hours$24.84 - $40.72 per hour
...accurate patient registration in the practice management system Reviews provider documentation for auditing purposes related to billing... ...registration practices Works with AR staff to resolve/appeal denials Works closely with Providers, offering assistance and education...Work at officeLocal area- ...waitlists for new and transfer applicants for public housing. Reviews and trains new employees, receiving onboarding training to prepare... ...Performs all the duties of the Applicant Review Specialist to include: Updates applicant waitlist records. Conducts...Permanent employmentFull timeWeekend workAfternoon shift
- ...To qualify for a Sourcing Strategy Specialist, your resume and supporting documentation... ...complex supply chain analysis studies; Utilizing data and Key Performance Indicators (KPIs... ...effectiveness and identify inefficiencies; reviewing supplier evaluations, identifying...Full timeRemote work
- ...Management And Oversight Of Teammates In The Closing Function. 2. Review And Execution Of Legal Documentation 3. Strong Knowledge Of... ...Routinely And Actively Engage With Teammates And Consistently Utilize And Model A One-Team Approach Qualifications Required Qualifications...
- ...Access Referral Specialist The Access Referral Specialist is a vital member... ...team for concurrent care review as needed. The Access Referral Specialist will utilize DocuSign to obtain signatures for... ...to Gilchrist providers, Access RN's and Hospital Liaisons Dispatch...Work at office
- ..., connected system. Our diverse team of medical specialists offers a wide range of treatment services, covering... ...communities we reach. What You’ll Do Collecting Review AR and follow up on unpaid accounts (including utilization of Artiva and/or specialized projects) Review...Work at officeLocal area
- ...The Home Depot is seeking an Asset Protection Specialist to prevent loss and safeguard customers and associates. You will monitor CCTV, review exception reports, and audit EAS systems to reduce shrink while supporting safety programs across stores. You will prepare detailed...
$62.4k - $98.8k
...communities around the globe. How will you make an impact? The EHS Specialist will establish and promote the maintenance of a safe, accident... ...processes; including user‑defined criteria, FAT and SAT reviews, PSSR, and other steps to ensure the appropriate review and validation...For contractorsWork at officeLocal areaWorldwide$26.96 per hour
...at Mercy Medical Center – Now Hiring a Coding Specialist II! Responsibilities The Coding Specialist II identifies, reviews, interprets, codes, and abstracts clinical... ...federal and state regulations and other agencies utilizing established coding principles and protocols....Hourly payTemporary workWork experience placementImmediate start- ...models. Position Summary The Total Rewards Specialist supports Team Member Operations (TMO) by... ...to: Benefits enrollment Claims and utilization Per employee per month (PEPM) costs Turnover... ...for: Total Rewards Committee Claims Review Tiger Team Leadership Team and Board presentations...Work at officeLocal areaShift work
- ...Authorization Specialist The Centers for Advanced Orthopaedics LLC (CAO) is one of the... ...understanding coverage information. # Utilize computer software programs, as needed, to... ...employment laws. For further information, please review the Know Your Rights notice from the...Work at officeRemote work
$19 per hour
...Position Purpose: The Asset Protection Specialist is primarily responsible for preventing... ...assigned store/multiple stores. They utilize tools to minimize loss to the Company, including... ...incidents of theft and fraud, reviewing CCTV and exception reports, monitoring the...Local area$24.25 - $42.5 per hour
...Job Overview Join to apply for the Coding Specialist III role at Inside Higher Ed . We are... ...Office of Billing Quality Assurance to review documentation. The specialist serves as... ...Charge Review Rules to prevent unnecessary denials. Works with Department Management on maintenance...Full timeContract workWork experience placementWork at officeMonday to Friday
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