RN Care Manager: Denials & Appeals Specialist
Direct Jobs
Direct Jobs is seeking a Care Manager Clinical Denials in Houston, Texas, responsible for managing audits and denials related to inpatient medical necessity. The role requires a Registered Nurse with extensive experience, particularly in case management and utilization management. This position demands comprehensive knowledge of healthcare regulations and effective communication skills for liaising with healthcare professionals. Flexibility in work schedule is also essential. #J-18808-Ljbffr
- ...opportunity for a Revenue Cycle Specialist II to support our... ...US: Senior Psych Care provides fully integrated... ...Responsible for managing and maintaining a workload... ...denied claims and submit appeals. Call payers to determine... ...the true reason for denial and inquire about what...SuggestedFull timeContract workTemporary workLocal areaImmediate startMonday to Friday
$14.9 - $29.06 per hour
...Services (CMS). Responsibilities Enters denials and requests for appeals into information system and prepares... ...service experience in a health care setting, or equivalent combination of... ...experience. Organizational and time management skills; ability to manage simultaneous...SuggestedRemote jobHourly payWork experience placementWork at officeWeekend work- Harris Health System in Houston is seeking a Care Manager Clinical Denials for full-time employment. This role involves managing clinical audits and... ...candidate will have a Bachelor of Science in Nursing, a Texas RN license, and at least five years of relevant experience in...SuggestedFull time
- ...Coding Denial Specialist What we do here changes the world. UTHealth Houston... ..., and excellence in patient care. That's where you come in.... ...department under the direction of the Manager, Charge Capture & Coding and... ...of coding related denials, appeal and submission, including...SuggestedFull timeFor contractorsLive inWork at officeRemote work
- A leading healthcare provider in Houston seeks a Revenue Cycle Specialist responsible for revenue cycle support and claims resolution. The ideal candidate should have a minimum of five years in commercial insurance follow-up, along with a high school diploma or equivalent...Suggested
$86.99k - $109.3k
...Care Manager Clinical DenialsHarris HealthFacebookXLinkedInShareDetails... ...: Care Manager Clinical Denials, Salary: $86,985.60 - $1... ...denied and whether an appeal is required. For all... ...Clinical Documentation Specialist (CCDS) OR Accredited Case Manager-RN (ACR) specialty...Full timeWork experience placementWork at officeFlexible hours$14.9 - $29.06 per hour
...healthcare provider in Houston is seeking an entry level support specialist for claims activities. Responsibilities include resolving member and provider complaints, entering denials, and preparing appeals documentation. Candidates should possess at least one year of...Hourly payWork at office- ...About the job Pediatric ECMO Specialist RN Nights The Pediatric ECMO Specialist RN is a critical care nurse trained to operate extracorporeal life support (ECLS... ...interventions during emergency situations by managing ECMO circuits, monitoring patient responses,...Night shift
$30 per hour
...national infusion company seeking experienced RN to join our team. This is a perfect... ...is hourly plus tips. Summary: An iV Specialists key role is to ensure clients are provided... .... Excellent Communication and Time Management Skills Proficient in using electronic...Hourly payReliefShift work- ...Blood in Houston is seeking a Registered Nurse for Medical Apheresis to perform complex apheresis procedures and provide high-quality care for patients and donors. This role involves overseeing procedures, maintaining equipment, and training staff in a supportive...
- ...A health services organization in Houston is seeking a Care Manager to oversee members with chronic conditions, ensuring comprehensive evaluations and resource coordination. The role requires registered nurse status with a Texas license, with a preference for CCM certification...Flexible hours
- ...Legacy Community Health is seeking a Registered Nurse - Care Manager in Houston, Texas, to make a meaningful impact on patient lives. In this collaborative role, you will work closely with multidisciplinary teams to provide holistic care that addresses health and social...
- ...Parkway - 2929 Allen Pkwy. Houston, TX 77019 Registered Nurse - Care Manager (Job Overview) Schedule: Monday-Friday (8AM-5PM) Are you... ...the care team. Coordinate services with primary care teams, specialists, home care providers, hospital teams, and managed care organizations...Temporary workMonday to FridayFlexible hours
- ...Revenue Cycle Specialist for Plaza OBGYN Assoc. Plaza ObGYN Assoc. is... ..., submitting claims, working denials, dealing with insurance companies... ...claims, posting payments, managing insurance denials and sending... ...the necessary follow-ups and appeals. Also will be coding, billing...Full timeMonday to Friday
- ...SeniorPsychCareishiring foranAuthorization Specialist. The position is... ...for approvals and denials Initiate and assist with appeals for denied authorizations... ...policy guidelines to manage authorization requirements... ...Detail-oriented focus; being careful about detail and thorough...Work at office
- ...Community Health Choice is seeking a Care Manager in Houston, Texas, to oversee members with chronic diseases and complex medical needs. The... ...outcomes. The ideal candidate must possess a current Texas RN license and CCM certification, or be willing to obtain it within...
- ...is seeking a PRN Cath Lab Registered Nurse to provide specialized care for patients undergoing cardiovascular procedures.... ...ideal candidate will have an Associate's Degree in Nursing, Texas RN license, and at least two years of relevant experience. Benefits...Relief
- Memorial Hermann Health System is seeking an RN for the Neuro ICU at Memorial City Hospital. This full-time role involves collaborating with healthcare teams to deliver exceptional patient care, ensuring compliance with Texas nursing standards. The ideal candidate will...Full timeDay shift
- ...discharge planning. The ideal candidate should have a nursing degree, current Texas RN license, and at least two years of inpatient psychiatric experience. Responsibilities include call management, initial assessments, and staff oversight. The position offers a competitive...
- ...for a Call Center Nurse to assess patient needs, provide clinical options, and refer to health care providers. This role requires a Bachelor's degree in nursing, a valid RN license from Texas, and at least 2 years of nursing experience in telehealth or similar settings...Monday to Friday
- Houston Methodist in Houston, Texas, is hiring a Registered Nurse (RN) II for Float Specialty Services. The role includes providing comprehensive nursing care, conducting assessments, and collaborating with the healthcare team to deliver high-quality patient care. Applicants...Full timeNight shiftDay shift
- ...institution in Houston is seeking a Registered Nurse to provide exceptional patient care and manage nursing assessments. The ideal candidate should possess a graduate education, Texas RN licensure, and twelve months of experience in a healthcare environment. Candidates...
- ...utilizes coding books to accurately assign codes for diagnoses, procedures, and other medical services or charges. Reviews claims denials and appeals to identify coding errors. Performs coding and billing corrections and charge reconciliations. Researches newly identified...Remote workTrial periodFlexible hoursDay shift
- ...Methodist, the Revenue Cycle Specialist is responsible for... ...support to the Revenue Cycle Managers. It is responsible for the... ...collections activities on complex denials and prepare complex appeals on outstanding insurance... ...for government, managed care, IPAs, and TPAs....
- ...Community Health in Houston is looking for a Registered Nurse - Care Manager to positively impact patients' lives through collaborative care... ...for professional growth. Applicants must have a valid Texas RN license and at least 3 years of acute care experience. #J-1880...
- A leading health institution in Texas is seeking a Manager of Care Coordination/Disease Management to oversee staff providing critical case management services to Health Plan members. The ideal candidate will ensure the needs of members and their families are met while...
- The Team Manager is the leader of the Patient Care Team and that member of the team whose function is to: supervise, evaluate and coordinate the various component members of the interdisciplinary team; assure continuity of care from admission to discharge or transfer to...Contract workLocal area
- A non-profit managed care organization in Houston is seeking a Care Manager to manage members with chronic diseases. The Care Manager will... ...Community Care Management programs. The ideal candidate will have an RN with a Texas license, experience in clinical settings, and...Flexible hours
$61.5k - $136.1k
HCSC seeks a Registered Nurse for a remote role focused on care management. Responsibilities include consulting with healthcare providers, coordinating... ...wellness education. Candidates should possess an active RN license and have experience in clinical and care management...Remote job- A prominent healthcare organization in Houston is seeking an experienced Manager of Care Coordination. This role involves overseeing case management for Health Plan members, ensuring that their needs are met while complying with various regulations. Candidates must possess...Full time
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