RN Denials & Utilization Audit Specialist
Northside Hospital Inc.
Northside Hospital Inc. in Atlanta is seeking a Clinical Case Management professional to process and appeal clinical denials while supporting Utilization Management efforts. The ideal candidate will be a graduate from an accredited nursing school with at least three years of experience in case management. The role requires excellent communication skills and the ability to work collaboratively with medical staff and managed care companies. This is a full-time position with work hours from 8am to 4:30pm. #J-18808-Ljbffr Northside Hospital Inc.
- ...Responsibilities Processes, tracks and appeals clinical denials. Supports and facilitates the design, development and implementation of Utilization Management data collection methodologies... ...criteria; knowledge of coding, billing, audit and reimbursement payer methodologies and...SuggestedWork at officeWeekend work
- ...development, and leadership programs… and more! Description The Utilization Review (UR) Specialist is a Registered Nurse responsible for conducting thorough... ...(s) based on the workflow. Follow the UR Department's denial workflows as appropriate. Prioritizes work with minimal...SuggestedWork at officeRemote work
- ...development, leadership programs and… more! Description The Registry Utilization Review Nurse (PRN) is responsible for conducting medical... ...with the attending physician and/or physician advisor. The UR RN (PRN) will perform utilization review by completing a timely and...SuggestedTemporary workCasual workReliefShift work
- Cross Country Nurses is looking for a travel nurse RN Utilization Review for a 14-week assignment in Atlanta, Georgia. This role entails performing medical necessity reviews for outpatient services, following guidelines like MCG and LCD criteria. Candidates must have prior...SuggestedDay shift
$2,645 per week
Job Summary Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Atlanta, Georgia. The organization is seeking a licensed UR RN to perform medical necessity reviews for outpatient services utilizing guidelines such as MCG, KP...SuggestedShift workDay shift- ...IR Lead in Atlanta, Georgia. The position is responsible for overseeing Insurance Representatives and managing claim follow-up and denial processes. This role involves training and supporting the team while ensuring compliance and performance metrics are met. The ideal...
- ...Services, Inc. in Atlanta, Georgia, is seeking an IR Lead responsible for guiding the Insurance Representatives team in claim follow-ups, denial management, and revenue recovery. The ideal candidate will bring 2-4 years of medical billing experience along with leadership...
- ...The Internal Audit organization is a highly efficient and effective risk/control assurance function. The team is consistently sought... ...ability to learn new IT Systems efficiently Data analytic skills, utilizing data and transactions to identify errors and provide business...Work at office
- ...Printpack is seeking a qualified Internal Auditor II to support audit and advisory activities that mitigate risk across our... ...strategic scoping* Perform complex corporate and plant internal audits utilizing outsourced internal auditors, including guest auditors and Ernst...Temporary workWork at office
- ...Troubleshoots and consults clients on all P&C lines, including disputes or denials by the carrier. Reviews, documents, and acknowledges pre‑... ..., practices, and rules and claims workflows; this position utilizes experience and judgment to plan, accomplish goals, and...
$71.1k - $97.8k
...Become a part of our caring community The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the... ...Required Qualifications: Must hold Compact Registered Nurse (RN) license in your state of residence Greater than one year of clinical...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workHome office$71.1k - $97.8k
...A healthcare company is seeking a Utilization Management Registered Nurse to support coordination and communication of medical services. The role requires a Compact RN license and over a year of clinical experience in relevant settings. Responsibilities include interpreting...Remote work$104.5k - $174k
A01098 GE Vernova International LLC is seeking an Internal Audit Staff member in Atlanta, Georgia. This role is vital for executing... ...requirements. Key tasks include overseeing financial audits and utilizing data analytics for process improvements. The ideal candidate has...$104.5k - $174k
Job Description Summary The Internal Audit Staff, Finance & Operations, is a key role responsible for the execution of assigned audits... ...executing a portfolio of financial and operational audits, utilizing data analytics to enhance audit effectiveness, and identifying...Relocation package- ...accountable for conducting and leading routine, medium and high‑risk audits or advisory reviews of areas concentrated within the electric... ...(public accounting/consulting firm/internal audit) or other utility industry experience is required Strong technical abilities...Work experience placementWork at office
- ...environment and supporting the continued maturation of the Internal Audit function. This position will focus on SOX compliance ,... ...communicate risks, root causes, and recommended solutions to management. Utilize AuditBoard to manage audit planning, execution, reporting, and...
$62.31k - $90.76k
...you will spend your time: Analyze business and personal financial statements and perform financial spreading of those statements. Utilize loan processing software to produce formal Loan Proposals for credit actions that will be presented for approval. Present solutions...Local areaFlexible hours$99k - $232k
...time Travel Requirements: Up to 60% The Opportunity As an IT Audit/Controls - Manager, you will play a pivotal role in delivering... ...strategic planning and execution of audit and assurance initiatives Utilizing technical proficiency in auditing methodologies and IT controls...Full time$99k - $232k
PwC is looking for an IT Audit/Controls Manager in Atlanta, Georgia. This role involves leading internal audits, managing client accounts, and utilizing innovative technologies to enhance audit processes. Candidates must have strong business knowledge, with at least a Bachelor...- ...Emory Healthcare in Atlanta is seeking a Registry Utilization Review Nurse (PRN) responsible for conducting medical necessity reviews utilizing Milliman and Interqual guidelines. This role requires effective communication with physicians, patients, and payers to ensure...Relief
- ...Job Title Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) Job Description The Clinical Utilization Review Nurse Preceptor (UR RN... ...high performing department. This will consist of regular audits of each staff member which will assist with identification...Temporary workCasual workShift work
$132.7k - $303.2k
...status, issues, or situations which need to be addressed Manage and monitor team's work, progress reporting, workload, quality and utilization/overtime distribution across the team Troubleshoot and identify complex process problems, process data submissions, analyze and...Work experience placementSummer holidayFlexible hours$35 - $45 per hour
...change in healthcare. * 2,500 Sign on Bonus ** As an Inpatient Auditing Specialist you will be instrumental in addressing consulting and... ...Will: Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate...Hourly payFull timeContract workInterim roleRemote workRelocation packageFlexible hours$35 - $45 per hour
...realize our bold vision for healthcare. Role As an Inpatient Auditing Specialist you will be instrumental in addressing consulting and... ...Responsibilities Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for...Hourly payFull timeInterim roleRemote workRelocation packageFlexible hours$80k - $110k
...Electrical Cost Estimator to support projects across the United States. The role involves developing capital cost estimates for various utility and transportation projects. Candidates should have 3-5 years of relevant field experience and knowledge of cost estimating...Work at office$103.6k - $189.9k
...in a high performing environment. You will oversee preparation and delivery of captive insurance feasibility studies and captive utilization projects, as well as captive insurance tax consulting memos and tax opinions. You will also be responsible for relationship management...Summer holidayLocal areaFlexible hours- ...of hands‑on experience in indirect sales and use tax compliance, audit defense, and tax technology. This role requires a strong problem... ...indirect tax issues and develop practical, compliant solutions. Utilize tax technology platforms and automation tools to enhance...
- ...of hands-on experience in indirect sales and use tax compliance, audit defense, and tax technology. This role requires a strong problem... ...tax issues and develop practical, compliant solutions.* Utilize tax technology platforms and automation tools to enhance accuracy...WorldwideFlexible hours
- ...accounting (either tax provision preparation or audit support) projects. The Corporate Tax... ...collaborate with other team members and specialists in our tax practice, including our... ...and consulting on various tax matters; Utilizing Tax-related software to prepare and process...InternshipSeasonal workWork at officeLocal areaFlexible hours2 days per week
- ...healthcare industry, and in people's lives. Overview The RN Clinical Nurse is a proactive member of an interdisciplinary... ...inclusive of all stakeholders, research and research utilization to promote safe, quality patient care including initiating and/...Relocation packageShift work
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