2 case manager rn jobs found in Jacksonville

Overview: Shape the future of clinical documentation and coding excellence. The CDI Manager provides strategic leadership for the Clinical Documentation Integrity program, overseeing provider engagement, CDI operations, and coding compliance. This role leads staff, drives process improvements, ensures accurate and timely coding, and maintains regulatory compliance while partnering across clinical and administrative teams to optimize documentation and performance outcomes. Responsibilities: Key Responsibilities   Lead the medical coding team to ensure accurate and timely coding in compliance with established standards and regulations. Develop, implement, and enforce coding policies and procedures. Coordinate ongoing training programs to enhance coder knowledge and expertise. Monitor productivity and accuracy metrics to support quality improvement initiatives. Collaborate with clinical and administrative teams to resolve coding issues and improve...

Overview: The Clinical Denial Management Nurse is responsible for completing, tracking, and reporting clinical denials at an enterprise level across all UF hospitals. Reporting to the Enterprise Denial Nurse Manager, this role supports Revenue Cycle functions including clinical departments, finance, accounting, compliance, patient financial services, revenue integrity, managed care, utilization review, and patient access.   The Clinical Denial Management Nurse serves as a clinical expert in denial management, ensuring all denied claims are reviewed from a clinical perspective and appropriately appealed to secure maximum reimbursement and minimize organizational write-offs. Responsibilities: Necessary Skills Knowledge of hospital billing and reimbursement, including Medicare/Medicaid denials, appeals, contracts, and healthcare regulations Ability to read and interpret Explanation of Benefits (EOBs) Strong critical thinking, analytical, and problem-solving skills High...