RN Denials & Appeals Specialist (Case Mgmt)
Boston Medical Center
Boston Medical Center is seeking a full-time RN Appeal Administrator responsible for managing the pre-denial and denial processes in healthcare services. This role requires collaboration with payers and ensures the clinical appropriateness of patient care levels. The ideal candidate must have a Bachelor's degree in Nursing, a current Massachusetts RN license, and at least five years of experience in healthcare case management. This position offers competitive compensation and a comprehensive benefits package. #J-18808-Ljbffr Boston Medical Center
$43.03 - $62.5 per hour
...Position Summary The RN Appeal Administrator will be responsible for the Pre‑denial / Denial and appeal process in addition to Utilization Review, validating the... ...denial of payments. Collaborates with physicians, case managers, revenue cycle personnel, and payers to appeal...SuggestedHourly payFlexible hours- ...A leading healthcare facility in Oklahoma City seeks a Hospital Denials Coordinator to manage insurance denial appeals and improve collections. The ideal candidate will have strong communication and organizational skills, at least two years of experience in insurance...Suggested
- ...Boston Medical Center is looking for an RN Appeal Administrator to oversee the Pre-denial and appeal processes within the Denials Access Department. This role... ..., with 5 years of working experience in healthcare case management, and must be licensed in Massachusetts. A...SuggestedWork experience placement
- North Oklahoma City billing office looking for an organized, self-motivated, results oriented individual to fill an Appeals Denial Management Specialist position Position Summary The Appeals/Denial Management Specialist performs daily activities associated with the timely...SuggestedContract workTemporary workWork at officeFlexible hours
$43.03 - $62.5 per hour
...Position Summary The RN Appeal Administrator will be responsible for the Pre-denial/ Denial and appeal process in addition to Utilization Review, to validate the... ...more related experience preferably in a healthcare case management and patient insurance/billing environment...SuggestedFlexible hours- Boston Medical Center (BMC) is seeking a Denials & Appeals Administrator (RN) responsible for managing the pre-denial and denial processes to ensure appropriate... ...'s Degree in Nursing, with 5+ years of healthcare case management experience. The ideal candidate will work...
$11 - $13 per hour
...page opens in new window Linkedin page opens in new window The Appeals department is the backend for when an insurance hasn’t paid a... ...an established medical billing company looking for an appeals specialist. We offer a relaxed atmosphere in a fast paced office environment...Contract workWork at office$50k - $86k
...accessible, high-quality, and sustainable healthcare for all. Coding Denials Management Associate We are looking for a Coding Denials... ...accurate workflows and procedures: claim corrections, resubmissions, appeals, or configuration updates; partner multiple stakeholders to...- ...seeking a Registered Nurse III in Oklahoma City to provide essential case management for infants with abnormal newborn screening results.... ...Program. The ideal candidate will hold a valid Oklahoma RN license and have at least two years of nursing experience. The position...
$24 - $24.5 per hour
Fallon Health in Worcester, MA is hiring a Healthcare Triage Administrator. This position supports the Appeals and Grievances process, handling member and provider interactions while ensuring compliance with regulatory standards. The ideal candidate will have a high school...Hourly pay$24 - $24.5 per hour
Fallon Health in Worcester, Massachusetts, seeks a Member Appeals & Grievances Intake Administrator responsible for administering the appeals and grievance process, ensuring compliance with various regulations. The role includes clerical support, handling member grievances...Hourly pay- ...OU Medicine in Oklahoma City is seeking an Experienced RN for the Breast Clinic at Stephenson Cancer Center. The role requires a dedication to patient care, effective communication, and the ability to manage diverse patient needs. Candidates must have an RN license and...Part time
$102k - $158.39k
Beth Israel Lahey Health, Inc. is looking for a Clinical Documentation Specialist II- RN to work remotely from Massachusetts. This position involves reviewing inpatient records for completeness and accuracy, improving physician documentation, and collaborating with various...Remote work$30 per hour
...local government entity in Massachusetts is looking for a Program Specialist Leisure Program Nurse to oversee health and medical records for... ...standards are met. The ideal candidate must hold a current RN Licensure and have experience working with youth. Compensation is...Hourly paySeasonal workLocal area$68k - $115k
A leading aerospace company in Oklahoma City is looking for a Project Management Specialist - Associate or Mid-Level. This role involves supporting NATO projects, ensuring successful project outcomes, and working collaboratively with cross-functional teams. Candidates...$58.66k - $142.45k
...identifying and clinically reviewing cases for peer‑to‑peer engagement... ...and/or MCG) to evaluate payer denials. Perform detailed clinical... ...reconsideration processes through RN‑to‑RN collaboration with... ...including additional reviews and appeal preparation. Participate in...Part time- ...examination of numerical data. Ability to synthesize clinical case data into concise summaries. Working knowledge of... ...level of care utilization. Investigates and prepares appeals for insurance companies when denial of reimbursement is related to medical necessity or to...Work experience placementWork at office
- ...Overview The Revenue Cycle Management Specialist- Collections responsibility is to ensure... ...to management for further action. Submit appeals/claim corrections as needed within timely... ...assigned. Identify and report trends in claim denials and payment challenges. Complete all...Work at office
- ...and ICD follow-up. The role requires 1 year of experience in this area, knowledge of cardiac arrhythmia interpretation, and a valid RN license. Candidates must possess excellent communication skills and be able to work a flexible schedule. Join a team committed to quality...Flexible hours
- ...support timely billing. Collaborates with billing staff to support denial prevention and revenue cycle accuracy. Answers incoming calls,... .... Maintains communication with referring providers, case managers, DRS counselors, and community partners to support continuity...Full timeWork at officeLocal area
- Aequor Healthcare is seeking a travel RN Stepdown for a role in Oklahoma City, Oklahoma. This position requires at least two years of proven experience in a Stepdown setting, working 12-hour shifts at 36 hours per week. The successful applicant will join a dedicated team...Weekly payShift work
$85.18k - $196.75k
...Boston Medical Center is seeking an RN Care Coordinator-Complex Case Manager to manage patient care and develop treatment plans. The position requires 3-5 years clinical experience and a strong understanding of utilization management. Responsibilities include coordinating...- ...Responsibilities The OHH Payment Variance Specialist I is responsible for triaging and... ...underpayments by insurance companies, drafting appeals as needed to obtain payment in full.... ...Credit Balances, or Insurance Follow-Up/Denials. Epic experience strongly preferred. Working...Contract workTemporary workReliefWork at officeFlexible hours
- Pine Street Inn is seeking a Case Manager to provide comprehensive support to homeless individuals in Boston. The position requires a High School Diploma and strong written communication skills. The Case Manager will work as part of a team using Harm Reduction and Motivational...
$120k - $130k
Share this job as a link in your status update to LinkedIn. Job Title Functional Title Contract position State Location Hanscom Air Force - MA US (Primary) Education Bachelor's Level Degree Job Type Full-time Job Description Quantech has an immediate opening for a Program...Full timeContract workWork at officeImmediate start- ...Case Manager RN CM's create and implement long-term care plans for patients. The Case Manager RN's goal is to coordinate patient care and... ...or SW liscensure or Masters or Bachelor's in SW. Cert in case mgmt or Rehab referred; Example CCM, ARN, ACM or CM by the ANCC. EHR...Casual work
$50k - $60k
...Point of Employee Contact Administer a full workload of ADA cases and associated leaves of absence for multiple clients, per client... ...policies, and benefits. Coordinate effectively with Claim Specialists to ensure that employee claims are adjudicated timely and accurately...Temporary workWork at officeRemote workMonday to Friday- ...A leading healthcare provider in Oklahoma City seeks a full-time RN Patient Safety Consultant. In this role, you will ensure caregiver safety through event investigation, education, and data analysis. The ideal candidate has over 5 years of healthcare experience, current...Full timeWork at office
- ...individual to fill a Full Time Receipt Posting Specialist position. Position Summary The Posting... ...AR system all payments, adjustments, denials and zero payments that are received into... ...team for a review and possible appeal. Maintains and follows list of payment...Full timeContract workTemporary workWork at officeFlexible hours
- ...graduates of accredited nursing programs and possess at least one year of nursing experience. Additional qualifications include a current RN license and BLS certification. The RN will collaborate with healthcare teams to enhance patient care and outcomes, with...
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