RN Clinical Finance & Denial Escalation Lead (Remote)
Ohio State University
The Ohio State University is looking for a Clinical Financial Case Manager - RN - Escalation Lead to provide advanced clinical appeal services, manage complex patient account denials, and assist in developing denial prevention strategies. This role offers the opportunity to work remotely and is ideal for a Registered Nurse with leadership capabilities. Candidates should have a minimum of 2 years' experience and be able to manage and oversee efficient workflows to enhance productivity while ensuring regulatory compliance. #J-18808-Ljbffr
- ...application. Job Title: Clinical Financial Case Manager - RN - Escalation Lead Department: Health System... ...of complex patient account denials. This role independently performs... ...Additional Information: Location: Remote Location Position Type:...Remote workShift workDay shift
- ...currently looking for a Clinical Financial Case Manager RN in United States.... ...focused on reducing denials and improving... ...clinical review and escalation. You will evaluate... ...escalations. Working in a remote setting, you will... ...to work within a leading academic health system...Remote jobFull timeDay shift
$45.29 - $84.11 per hour
...better. Hybrid/Remote Summary: The purpose of the Denial Prevention Nurse is to ensure... ...timely and accurate clinical information to all... ...obstacles and deny claims and escalating any egregious payer... ...field Required: Current RN License in Connecticut and...Remote workHourly payDaily paidPart timeShift workNight shiftRotating shift- ...Ohio RN Clinical Finance Specialist is a full-time remote position responsible for implementing clinical finance strategies, securing pre-authorizations, and managing clinical denials. Key Responsibilities Implement and support clinical finance strategies to secure pre...Remote workFull timeWork at office
- ...Overview Work remotely with a collaborative enterprise denials team focused on reimbursement accuracy... ...-Time (1.0 FTE) The Clinical Denial Management Nurse... ...clinical departments, finance, accounting, compliance,... ...nursing as a Registered Nurse (RN) or Licensed Practical...Remote workFull timeWork at office
$80k - $90k
...organization. Machinify is a leading healthcare intelligence... ...-90k The Medical Review Clinical Appeals Auditor (RN) is responsible for conducting... ..., providing supplemental escalation support, and may perform... ...to work independently in remote setting with minimum supervision...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work- ...UnitedHealth Group, Inc. is seeking a full-time Coding Denials Supervisor to lead a team of coding denial specialists. The role involves overseeing... ..., quality auditing, and compliance monitoring, all in a remote setting. The ideal candidate will ensure accurate coding practices...Remote workFull time
$102.18k
Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Location: Los Angeles, CA, US, 90017 Position... ...of complex and/or escalated clinical A&G cases... ...the root cause of denials. Check, verify and... ...holidays, a hybrid remote schedule, and occasional...Remote workFull timeShift workWeekend work$60.2k - $107.4k
..., is seeking a Coding Denials & Auditing Supervisor... ...Coding to join our team in Remote, Nationwide . Optum is... ...Optum, you'll have the clinical resources, data and... ...initiatives. The Supervisor leads a team of coding denial... ...medical necessity) and escalate systemic issues...Remote workMinimum wageFull timeTemporary workWork experience placementLive inLocal areaWork from homeMonday to Friday- ...appealing claims when appropriate to overturn clinical denials from Medicare, Medicaid, and other third... ...and staff. What you bring Licensed RN. At least 2 years’ experience in an... ...duties and requirements. This position is remote and requires a dedicated, distraction‑free...Remote workTemporary workWork from home
- ...and APR-DRG coding methodologies, the full-time Minnesota Licensed Clinical Auditor RN will conduct audits of inpatient claims, validate coding accuracy, and identify overpayments while working remotely from anywhere in the U.S. Key responsibilities: Conduct MS-DRG and...Remote workFull time
- ...Providing clinical review support on a full-time remote basis, the RN Clinical Review Specialist will review medical records... ..., and authorization-related denials Review inpatient and outpatient... ...collaborate with clinical leadership for escalations or complex cases Required...Remote workFull time
- ...A company is looking for a Clinical Auditor Registered Nurse. Key Responsibilities Review medical records and documentation for compliance... ...while maintaining detailed workpapers Required Qualifications RN license preferred; Indiana or compact license accepted Coding...Remote work
- ...Working remotely, the full-time Clinical Validation Auditor RN will apply expert knowledge of MS-DRG and APR-DRG coding methodologies to audit inpatient claims, validate ICD-10 codes, and identify overpayments while composing rationales to support audit findings. Key...Remote workFull time
- ...Focused on Coding and Clinical Chart Validation, the full-time Clinical Auditor Licensed RN will independently audit outpatient and specialty claims, ensuring coding accuracy and medical necessity while utilizing advanced audit tools and maintaining productivity standards...Remote workFull time
- ...Clinical Staff Leader Discover Vanderbilt University Medical Center... ...leadership team. The CSL leads a cohort of staff members and... ...quality, service, compliance, finance, throughput and scheduling. The... ...are based. Appropriately escalates problems relating to rules and...Temporary workFlexible hoursShift work
- ...To support clinical auditing efforts, the full-time RN Clinical Auditor will perform retrospective chart reviews on Readmission and Place of Service Claims, utilizing clinical guidelines and proprietary systems while maintaining productivity and accuracy standards. Key...Remote workFull timeWork at office
- ...is one of the nation's leading children's hospitals.... ...completion of appropriate clinical review of all... ...weeks. This role will be remote, including most training... ...of care using Epic and escalating cases for status... ...review process, aids in denial prevention, and serves...Remote workRelief3 days per week
- ...in Nashville, Tennessee, is a leading institution focused on... ...and research. Job Summary The Clinical Staff Leader (CSL) is a registered... ..., service, compliance, finance, throughput, and scheduling strategies... ...rules and regulations, and escalates problems in a timely manner....Temporary workWork experience placementFlexible hoursShift work
- A leading health company in Colorado is seeking a Diagnosis Related Group Clinical Validation Auditor-RN. The role involves auditing inpatient medical records, ensuring compliance with... ...salary and benefits with flexible remote work options. #J-18808-Ljbffr Elevance HealthRemote jobFlexible hours
- ...seeking a detail-oriented Registered Nurse Clinical Auditor to support medical record reviews... ...Indiana Health Coverage Programs. This remote role requires evaluating provider compliance... .... Applicants should preferably hold an RN license, coding certification, and have...Remote job
$25 - $30 per hour
...Lean Growth Organization | Remote Department: Finance Location: California (Remote... ...00 / hour Claims Follow-Up Lead WellPsyche Medical Group is... ...for resolving complex denials, accelerating accounts receivable... ...timely filing limits. Escalate payer issues strategically...Remote workFull timeWork from homeHome office- ...looking for a detail-oriented Registered Nurse Clinical Auditor to conduct medical record reviews... ...Indiana Health Coverage Programs. This remote position requires evaluating care quality... .... The ideal candidate holds an RN license, has at least one year of relevant...Remote job
- RADcube is seeking a detail-oriented Registered Nurse Clinical Auditor for a remote position with occasional travel in Indiana. The role involves conducting... ...Coverage Programs. Key qualifications include a preferred RN license, coding certification (CCS or CPC), and at least...Remote job
- Innovative Renal Care is seeking a Clinical and Regulatory Manager (RN) with dialysis expertise to lead clinical quality and regulatory compliance. This role involves improving patient outcomes through data analysis and collaboration with clinical teams across Georgia...Remote job
- RN Clinical Denial Auditor Job Category: Nursing Schedule: Full time Shift: 1 - Day Shift Summary Responsible for reviewing and appealing clinical denials, tracking clinical denial trends, identifying continuous improvement opportunities. Responds to any compliance...Full timeShift workDay shift
$100k - $136k
VNA Care is seeking an RN Clinical Manager for the Dorchester Team in Boston. This position involves overseeing a team of home health nurses... ...of $100,000 - $136,000 a year, with a mix of in-office and remote work. Benefits include medical, dental, vision, and generous...Remote jobWork at office$29 - $46.5 per hour
...heartland. Facility: Remote SD (Central Time)... ...Job Summary The Lead UM Specialist serves as... ...expert for appeals and denials, provides leadership, case... ...requirements. Conduct review of clinical-based denials (i.e.... ...unencumbered registered nurse (RN) license with the State...Remote workFull timePart timeWork from homeShift workDay shift- ...RCS-Coding Clinical Team Lead This position is responsible for leadership of assigned clinical teams within IU Health Revenue Cycle Services... ...with relevant national benchmarks. Serves as the first tier escalation for clinical team members on task oriented problems or...Remote workLocal area
- ...Job Title: Clinic RN Team Lead - NRV Description Employment Status:Full timeShift:Day (United States of America)Facility:290... ...state of Virginia. For Psychiatry and Behavioral Health - de-escalation training must be successfully completed within four months...Local areaMonday to Friday
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