Clinical Denials Specialist
2 days ago
Vidant Health is seeking a skilled Clinical Denials Specialist to join our team. As a key member of our appeals team, you will be responsible for reviewing denied claims and ensuring timely and accurate appeals to maximize reimbursement and minimize recoupment.
Key Responsibilities- Review medical records to determine whether each case should be appealed, downgraded, or referred to physician advisors
- Write comprehensive and concise appeals utilizing appropriate screening tools and payer policies
- Perform timely medical record audit reviews for accuracy
- Track all denial/appeal activity and identify trends
- Review response letters from insurance carriers and follow up as necessary
- Bachelor of Science in Nursing or Associate Degree in Nursing with 10 years of experience in Case Management, Utilization Review, or Clinical Documentation Improvement
- 5 years of related work experience within Case Management, Utilization Review, or Clinical Documentation Improvement
Vidant Health offers a competitive salary and benefits package, as well as opportunities for professional growth and development.
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Supervisor, Denials Management
3 days ago
Greenville, North Carolina, United States Vidant Health Full timeJob Title: Supervisor, Denials ManagementAbout the Role:The Supervisor, Denials Management will be responsible for analyzing, tracking, measuring, preventing, and managing denials in collaboration with all areas of revenue cycle management. This role will work closely with the Manager/Director to provide staff oversight and assistance, ensuring timely and...
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Clinical Utilization Specialist
3 weeks ago
Greenville, North Carolina, United States Vidant Health Full timeJob Title: Clinical Utilization SpecialistCompany: Vidant HealthAbout Vidant HealthVidant Health is a leading healthcare provider in eastern North Carolina, dedicated to delivering high-quality patient care and advancing medical education and research.Job SummaryThe Clinical Utilization Specialist will play a critical role in ensuring regulatory compliance...
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RCM AR Specialist
2 days ago
Greenville, South Carolina, United States Crossroads Treatment Center Full timeJob Title: RCM AR SpecialistCrossroads Treatment Centers is an equal opportunity employer, committed to creating an inclusive environment for all employees. We are seeking a skilled RCM AR Specialist to join our team.Job Summary:The RCM AR Specialist will be responsible for resolving new and aged accounts receivables, utilizing industry knowledge to analyze...
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Utilization Review Specialist
2 weeks ago
Greenville, South Carolina, United States Vidant Health Full timeJob Title: Utilization Review Specialist About Vidant Health Vidant Health is a leading healthcare system in North Carolina, providing comprehensive care to patients across the region. Our team of dedicated healthcare professionals is committed to delivering high-quality patient care and improving the health of our communities. Job Summary: The...
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Clinical Nurse Specialist
3 days ago
Greenville, South Carolina, United States Prisma Health Full timeJob Title: Clinical Nurse SpecialistAt Prisma Health, we are seeking a highly skilled Clinical Nurse Specialist to join our team. As a Clinical Nurse Specialist, you will be responsible for providing clinical direction for all aspects of patient care in an acute inpatient setting.Key Responsibilities:Provide clinical direction for all aspects of patient care...
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Clinical Nurse Specialist
4 weeks ago
Greenville, South Carolina, United States Prisma Health Full time{"Job Title": "Clinical Nurse Specialist", "Job Summary": "At Prisma Health, we are seeking a Clinical Nurse Specialist to join our team. As a Clinical Nurse Specialist, you will provide clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Key Responsibilities: Collects data and...
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Clinical Nurse Specialist
4 weeks ago
Greenville, South Carolina, United States Prisma Health Full time{"Job Title": "Clinical Nurse Specialist", "Job Summary": "At Prisma Health, we are seeking a Clinical Nurse Specialist to join our team. As a Clinical Nurse Specialist, you will provide clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient/family centered care. Key Responsibilities: Collects data and...
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RCM AR Specialist
3 days ago
Greenville, South Carolina, United States Crossroads Treatment Center Full timeAbout the RoleCrossroads Treatment Centers is an equal opportunity employer, committed to creating an inclusive environment for all employees. As an AR Specialist, you will play a vital role in supporting our patients' medical and personal recoveries from substance use disorder.Key ResponsibilitiesPerform all duties and responsibilities in accordance with...
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Clinical Nurse Specialist
2 weeks ago
Greenville, South Carolina, United States Prisma Health Full timeJob Title: Clinical Nurse SpecialistAt Prisma Health, we are seeking a highly skilled Clinical Nurse Specialist to join our team. As a key member of our healthcare team, you will be responsible for providing clinical direction and leadership in the delivery of patient care services.Key Responsibilities:Develop and implement evidence-based nursing practices...
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Clinical Specialist II
8 hours ago
Greenville, South Carolina, United States Abbott Full timeAbout AbbottAbbott is a global healthcare leader that empowers people to live their best lives. With a portfolio of life-changing technologies, we're advancing the treatment of heart disease through innovative medical technologies.The OpportunityIn Abbott's Electrophysiology (EP) business, we're pushing the boundaries of medical science to improve patient...
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Cancer Clinical Nurse Specialist
4 weeks ago
Greenville, South Carolina, United States Vidant Health Full timeClinical Nurse Specialist - Cancer CareThe Clinical Nurse Specialist (CNS) is a master's and/or doctorally prepared advanced practice registered nurse who is nationally board certified in an area of clinical expertise or specific patient population.This role functions as a leader, innovator, and change agent, striving to meet the needs of patients, families,...
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Clinical Pharmacist Specialist
1 day ago
Greenville, South Carolina, United States Prisma Health Full timeTransforming Healthcare TogetherAt Prisma Health, we're committed to delivering exceptional patient care and inspiring health. As a Clinical Pharmacist Specialist, you'll play a vital role in our multidisciplinary healthcare team, providing leadership and pharmaceutical excellence through direct patient care activities.Key Responsibilities:Lead patient care...
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Clinical Nurse Specialist
4 weeks ago
Greenville, South Carolina, United States Prisma Health Full timeJob SummaryAs a Clinical Nurse Specialist at Prisma Health, you will play a vital role in providing high-quality patient care in an acute inpatient setting. Your expertise will be essential in fostering patient-centered care, ensuring that each patient receives the best possible treatment.Key ResponsibilitiesDevelop and implement individualized plans of care...
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Clinical Nurse Specialist
3 days ago
Greenville, South Carolina, United States Prisma Health Full timeJob SummaryAs a Clinical Nurse Specialist at Prisma Health, you will play a vital role in providing exceptional patient care in our Pediatric Hematology department. Your expertise will be instrumental in fostering a patient-centered environment, where you will work collaboratively with the healthcare team to deliver high-quality care.Key...
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Greenville, South Carolina, United States VETERANS HEALTH ADMINISTRATION Full timeAbout the JobThis position is located in the Audiology & Speech Pathology Section of the Greenville Community Based Outpatient Clinic (CBOC). The Clinical Specialist provides leadership and directs oversight in the design, development, implementation, planning and management of the ASP-traineeship program.Key ResponsibilitiesProvides orientation/training of...
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Clinical Nurse Specialist
3 days ago
Greenville, South Carolina, United States Prisma Health Full time{"Job Summary": "As a Clinical Nurse Specialist at Prisma Health, you will be responsible for providing clinical direction for all aspects of patient care in an acute inpatient setting. You will foster patient/family centered care and demonstrate clinical competency utilizing evidence-based practices/research in all areas of the nursing process: assessment,...
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Clinical Nurse Specialist
2 weeks ago
Greenville, South Carolina, United States Prisma Health Full timeJob SummaryAs a Clinical Nurse Specialist at Prisma Health, you will provide clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient-centered care. You will demonstrate clinical competency utilizing evidence-based practices and research in all areas of the nursing process, including assessment, planning,...
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Clinical Specialist, Cardiac Rhythm Technologies
3 weeks ago
Greenville, South Carolina, United States Abbott Laboratories company Full timeJob SummaryWe are seeking a highly skilled Clinical Specialist to join our team at Abbott Laboratories. As a Clinical Specialist, you will provide engineering, sales, educational, and technical support to healthcare professionals, patients, and field sales staff, focusing on CRM products.Key ResponsibilitiesProvide clinical support and technical expertise to...
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Clinical Nurse Specialist
4 weeks ago
Greenville, South Carolina, United States Prisma Health Full timeJob SummaryWe are seeking a skilled Clinical Nurse Specialist to join our team at Prisma Health. As a key member of our healthcare team, you will be responsible for providing high-quality patient care in an acute inpatient setting.Key ResponsibilitiesProvide clinical direction for all aspects of patient care, fostering a patient-centered approach.Develop and...
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Clinical Nurse Specialist
4 weeks ago
Greenville, South Carolina, United States Prisma Health Full timeJob SummaryAs a Clinical Nurse Specialist at Prisma Health, you will provide clinical direction for all aspects of patient care in an acute inpatient setting, fostering patient-centered care. You will demonstrate clinical competency utilizing evidence-based practices and research in all areas of the nursing process, including assessment, planning,...