Denial Management Professional
2 days ago
We are seeking an experienced nurse to fill the role of Clinical Denials Specialist at Northwell Health. As a key member of our team, you will be responsible for reviewing denial trends, identifying coding issues, and collaborating with healthcare professionals to resolve disputes.
About the Job- Work Schedule: Remote work schedule (Sun-Thurs, 8AM-4PM)
This position requires a strong understanding of regulatory standards, clinical protocols, and business operations. Your ability to analyze complex data, identify patterns, and develop strategic solutions will be essential in driving operational efficiency and improving patient outcomes.
Key Responsibilities- Clinical Expertise: Leverage your nursing background to provide expert guidance on medical necessity, coding, and billing procedures.
- Communication Skills: Effectively collaborate with healthcare teams, payers, and patients to resolve disputes and improve communication channels.
- Process Improvement: Analyze existing workflows, identify areas for improvement, and implement data-driven solutions to optimize operational efficiency.
- Regulatory Compliance: Ensure adherence to relevant laws, regulations, and industry standards, maintaining the highest level of integrity and professionalism.
- Nursing Education: Bachelor's Degree in Nursing or equivalent required; Master's Degree preferred.
- Licensure: Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed.
- Experience: Prior experience in Case Management, Utilization Review, and Appeals/Denials highly preferred.
The salary range for this position is approximately $90,000 - $115,000 annually, based on factors such as location, experience, and education.
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Clinical Denials Specialist
2 days ago
Melville, New York, United States Northwell Health Full timeAt Northwell Health, we are seeking a skilled Clinical Denials Specialist to join our team.About the Role:We are looking for a highly motivated individual with experience in Case Management, Appeals & Denials, and/or Utilization Review. The successful candidate will have a strong background in nursing, with a Bachelor's Degree in Nursing preferred. As a...
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Healthcare Financial Professional
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Data Center Management Professional
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Business Intelligence Analyst
2 weeks ago
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Accountable Revenue Recovery Specialist
2 weeks ago
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Healthcare Billing Specialist
2 weeks ago
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Business Intelligence Analyst
2 days ago
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Claims Management Professional
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Estate Planning Professional
3 weeks ago
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Pricing Analyst Professional
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Healthcare Contract Professional
3 weeks ago
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Senior Tax Professional
3 weeks ago
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Insurance Business Development Professional
2 weeks ago
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Pricing Expert Associate Professional
2 weeks ago
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Expert Wound Care Professional
3 weeks ago
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Melville, New York, United States NAPA Management Services Corporation Full timeNAPA Management Services Corporation is a leading provider of anesthesia services nationwide. Our team of experienced professionals is dedicated to delivering exceptional patient care and satisfaction.We're seeking a qualified Anesthesiologist to join our team, providing comfort and safety for patients in a fast-paced hospital environment.Salary Range:...
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Amusement Equipment Maintenance Professional
2 days ago
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Melville, New York, United States New York Life Full timeCareer Overview:New York Life offers a dynamic career opportunity for motivated individuals to join our team as Financial Service Professionals. As a member of our organization, you will have the chance to develop a long-term financial strategy with clients and contribute to their overall well-being.Compensation:We offer an estimated annual salary range of...
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Pricing and Business Development Professional
2 weeks ago
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