RN Case Manager

Location: CHA Cambridge Hospital
Category: Registered Nurse
Department: Inpatient Case Management CH
Job Type: Full time
Union Name: MNA Cambridge

Work Schedule: Day
Shift Details: 7-3:30pm
Hours/Week: 36.00

Inpatient Case Management provides psychosocial assessments, evaluations, and referrals for adults, and/or families with psychiatric illness, substance abuse, and medical illness. Casework or therapy takes place in the hospital setting. Cross Training to all areas of Care Management

An Appeals and Denials Nurse works to ensure that hospitals receive appropriate reimbursement from insurance companies by reviewing and appealing denied medical claims. Responsibilities include:
- Review insurance claim denials and identify the reason for denial.
- Analyze medical records to determine if the care provided met medical necessity criteria.
- Prepare and submit appeal letters with supportin...