Denials & Appeals Coordinator - Utilization Review
$21 - $24.45 per hourSt. Francis Medical Center
St. Francis Medical Center in Lynwood is seeking a dedicated Utilization Review Tech to join their team. This role focuses on coordinating the utilization review and appeals process, tracking communications with insurance providers, and managing denial processes. The ideal candidate should possess denials management experience, strong data entry skills, knowledge of medical terminology, and a high school diploma or equivalent. The position offers full-time hours, competitive compensation ranging from $21.00 to $24.45 per hour, along with a comprehensive benefits package that includes paid time off, a 401K retirement plan, and more. #J-18808-Ljbffr St. Francis Medical Center
- Join Prime Healthcare as a Utilization Review Tech at St. Francis Medical Center in... ...California. This role involves coordinating the utilization review and appeals process, managing communications... ...candidate will have experience in denials management within an acute care...SuggestedFull time
$21 - $26 per hour
...Overview: We are seeking a detail-oriented, proactive Utilization Review (UR) Coordinator to support insurance authorization processes across... ...improve processes and enhance coordination of care Denials & Appeals Support: Assist with denial management, support...SuggestedHourly payFull time$70k - $80k
...delivering exceptional care, utilizing state-of-the-art facilities,... ...! Title: Utilization Review Coordinator Reports to: Director of... ...authorizations, retro-authorizations, appeals, medical records requests,... ...internal authorization or denial determinations for No...SuggestedFull timePart timeRemote work$21 - $26 per hour
...UM Coordinator - Denials Astrana Health is seeking a dedicated Utilization Management (UM) Coordinator Denials to join our Denial Department... ...UM Coordinator Denials will review, monitor, and process prior... ..., Denial Inquiries, and Appeal/Grievance Inquiries. Report...SuggestedHourly payWork at officeWeekend work$74.16 - $107.75 per hour
...UCLA Outpatient Clinics is seeking a Utilization Review Nurse for its Utilization Management Department at the Resnick Neuropsychiatric Hospital... ...with third party payors for authorization and managing appeals. Candidates will collaborate with treatment teams and financial...SuggestedHourly pay$74.16 - $107.75 per hour
...Description The Utilization Review Nurse is part of the Utilization Management Department at the Resnick Neuropsychiatric Hospital... ...and the revenue cycle team. Follows up on payor denials and initiates appeals. Provides consultation to treatment team members regarding...Work at office$21.78 - $31.52 per hour
...communities we serve.The JobThe Grievances and Appeals Senior Coordinator will provide support to grievance and... ...support/guidance to team members, review of cases prior to closure and... ...relates to Grievances and Appeals services.Utilize department desktop procedures, workflows...For contractorsWork at office$32.7 - $47.2 per hour
...Job Description Job Description Position Summary The Utilization Review Coordinator oversees the completion of all admission and concurrent reviews of all MediCal patients. Completes MediCal Treatment Authorization Requests (TAR) for the Organization. Uses “level...Full timeWork at officeLocal area$56 per hour
Position Summary The Utilization Review/Management Nurse is accountable for... ...is also responsible in coordinating the Physician Advisor review... ...clinical indicators Communicates denials and physician‑related... ...condition that would aid in the appeals process. Required...Full timeLocal areaImmediate start$47.2 - $63.45 per hour
...achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness. Qualifications EDUCATION, EXPERIENCE...Full timePart timeWork experience placementLocal areaShift work$74.16 - $107.75 per hour
Veterans in Healthcare is looking for a Utilization Review Nurse to work in Los Angeles, CA. This role is part of the Utilization Management Department at the Resnick Neuropsychiatric Hospital and supports various treatment programs. The ideal candidate will perform clinical...Hourly payMonday to Friday$55.56 - $85.96 per hour
...A healthcare facility in California is seeking a Utilization Review Case Manager to validate patient admissions and levels of care. The role involves performing patient chart reviews, securing authorizations for clinical services, and collaborating with healthcare teams...Hourly pay$74.29k - $111.43k
...consumers are entitled to high‑quality, coordinated care. By uniquely aligning the... ...experience for all. Job Summary The Concurrent Utilization Review (UR) Nurse is responsible for... ...clinical leadership for complex cases, denials, and escalated reviews. Key Responsibilities...Work at office$88.85k
...Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position... ...pre-payment review processes, helps reduce unnecessary denials, and monitors for potential fraud, waste, and abuse (FWA...Full time$30 - $45 per hour
...opportunity in Long Beach, CA. This role requires expertise in Medicaid and Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will perform chart reviews, ensure documentation accuracy, and support Medicaid program metrics. This...Hourly payContract workRemote work- Position Overview: The Utilities Coordinator III/Virtual Design and Construction (VDC) works closely with the BIM Manager. Position Description... ...of CMMS data for impacted facilities and infrastructure. Review and upload equipment data from completed As-Builts to CMMS....Local area
$25.13 - $37.96 per hour
Torrance Memorial Medical Center is hiring a Utilization Review Assistant to ensure utilization management documentation and information requirements are met. The role includes coordination between various departments and managing payer communications. The ideal candidate...Hourly pay$56 - $70 per hour
A leading healthcare organization is seeking a Utilization Review/Management Nurse in California. This role involves planning and overseeing daily utilization review operations and coordinating discharge planning for complex patients. Candidates must have a current Registered...Hourly pay- Vaco by Highspring is seeking a Denials Patient Account Representative for a temporary position at a community hospital in Torrance, CA. This role involves appealing insurance denials and supporting the revenue cycle team, with potential for extension and conversion to...Permanent employmentTemporary work
- ...Effectiveness Consulting Group, LLC in Monterey Park is seeking a Case Manager RN or LVN to join our Utilization Review Department. This per diem position involves coordinating care for patients, conducting admissions, and liaising with health plans to ensure appropriate...Daily paid
$3,499 per week
...Registered Nurse (RN) | Utilization Review Location: Los Angeles, CA Agency: GQR Healthcare Pay: $3,499 per week Shift Information: Days - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: ASAP About the Position Contract - W...Hourly payWeekly payFull timeContract workImmediate startShift work$3,499 per week
...Registered Nurse (RN) | Utilization Review Location: Los Angeles, CA Agency: GQR Healthcare Pay: $3,499 per week Shift Information: Days - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: ASAP About the Position TravelNurseSource...Hourly payWeekly payFull timeContract workImmediate startShift work$1,854 per month
...an experienced Registered Nurse (RN) – Utilization Review to assess the medical necessity,... ...justifications for medical necessity appeals and authorizations Analyze utilization... ...cost-effective patient care Assist in denials management and appeals processing Stay...Shift work- ...Manages the day-to-day operations of the Utilization Management Program in the Service Area... ...the multi-disciplinary teams to plan and coordinate care across the continuum. Coordinates... ...to staff regarding utilization review, care coordination, discharge planning,...Local area
$71k - $151k
...Registered Nurse - Utilization Review Hospitals on Incredible Health are hiring and accepting applications in the Los Angeles, CA area. Work Details Shift(s) available: day shift Job types available: full time and part time Qualifications RN Diploma degree or higher from...Full timePart timeShift workDay shift$2,800 per month
...Profession Registered Nurse Specialty Utilization Review Job ID 18027156 Job Title Utilization... ...compliance with CMS, EMTALA, and regulatory guidelines while coordinating authorizations and reimbursement Client Details...Weekly payShift work- ...Experience by Specialty Pediatrics* ICU MS Case Management/Utilization Review Pre-Cert Review* Prior Authorizations* Retrospective Review* Admission Criteria Care coordination Concurrent Review Continued Stay Reviews Determine Medical Necessity...Remote work
- ...Jr. Community Hospital is seeking a skilled RN Utilization Management professional to function as a... ...liaison for various UM functions. The role involves coordinating care from admission to discharge, managing clinical denials, and ensuring adherence to health plan...
- 1st TIME OK/ 2 YR EXP required for Utilization Review RN every other weekend required or more depending on unit needs no call or floating... ...Department ICU Admission Criteria Benefits Eligibility Care coordination Concurrent Review Data Abstraction Determine Medical...Casual workWeekend work
$71k - $151k
...Registered Nurse - Utilization Review Hospitals on Incredible Health are actively hiring and accepting applications in the Los Angeles, CA area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are...Full timePart timeShift workDay shift
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