Top 15 Rn utilization review Jobs in Columbus

Patient Financial Specialist III
Mount Carmel —Columbus, OH
- Full-time
- Surgery
- Hospital
- Customer service
- Relocation assistance
- Health insurance
Nurse - Skilled/Purchased Care Coordinator
US Veterans Health Administration —Columbus, OH
- $70,726 - $148,921 a year
- Online Application
- Hybrid work
- Background check
- Nursing
- Doctoral degree
- Paid holidays
- Dental insurance
5d
Utilization Review Specialist
Lighthouse Behavioral Health Solutions —Columbus, OH
- Nursing
- Management
- Pass drug screening
- Paid holidays
- Health insurance
Quick Apply
Denials RN Coordinator
Ensemble RCM LLC —Columbus, OH
- $62,500 - $79,800 a year
- Full-time
- Nursing
- RN License
- 5 years
- Tuition reimbursement
RN, LSW, LISW, Care Manager - Columbus
Careforth —Columbus, OH
- $62,657 - $84,173 a year
- Full-time
- Hybrid work
- RN License
- Experience working with individuals with disabilities
- Mid-level
- Wellness program
- Flexible schedule
Case Manager / PRN ( RN / RT / SW / LPN )
Select Specialty Hospital - Columbus Vic Village(Grant) —Columbus, OH
- Part-time
- Master of Social Work
- RN License
- Inpatient
- Employee assistance program
- Opportunities for advancement
Quick Apply
9d
MDS Nurse Transition Leader
Otterbein SeniorLife —Columbus, OH
- Nursing
- RN License
- 5 years
- Paid holidays
- Dental insurance
Quick Apply
LPN Operations Manager - Senior Home Care
Visiting Angels Columbus West —Columbus, OH
- $62,000 - $68,000 a year
- Full-time
- Bachelor's degree
- Home Health
- Senior level
- Retirement plan
Quick Apply
Nurse Manager (RN)
Columbus Springs Dublin —Dublin, OH
- Full-time
- Nursing
- RN License
- Inpatient
- Free parking
- Health savings account
Quick Apply
Home Health Clinical Supervisor
Ohio Living —Westerville, OH
- Weekends as needed
- Nursing
- Clean driving record
- Microsoft Excel
Quick Apply
Appeal Analyst RN | Remote | Contract
Walker Healthforce, LLC —United States
- Contract
- Remote
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Quick Apply

More jobs to discover

Find similar jobs that you might be interested in.

Nurse - Skilled/Purchased Care Coordinator
US Veterans Health Administration —Columbus, OH
Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the…
$70,726 - $148,921 a year
5d

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Patient Financial Specialist III
Mount Carmel —Columbus, OH
Working knowledge of medical terminology, and data entry skills. Contacts physicians/office staff for clarification, if cases require clarification of diagnosis…
Nurse - Skilled/Purchased Care Coordinator
US Veterans Health Administration —Columbus, OH
Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the…
$70,726 - $148,921 a year
5d

Show more jobs in cities nearby

I want to receive the latest job alert for rn utilization review in columbus

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

rn utilization review jobs near columbus

Utilization Review Nurse jobs in Columbus, OH

Licensed Practical Nurse jobs in Columbus, OH

Shift Leader jobs in Columbus, OH

Purchasing Coordinator jobs in Columbus, OH

Nurse Coordinator jobs in Columbus, OH

Nurse Chart Review jobs in Long Island, NY

Dialysis Nurse jobs in Fresno, CA

Utilization Review Nurse jobs in Chicago, IL

Utilization Review Nurse jobs in Albuquerque, NM

Utilization Review Nurse jobs in Olympia, WA

Utilization Review Nurse jobs in Burbank, CA

Nurse Manager jobs in Irvine, CA

Nurse Manager jobs in Illinois

Psychiatric Mental Health Nurse Practitioner jobs in Baton Rouge, LA

Radiology Manager jobs in North Carolina

House Manager jobs in Long Island, NY

Nurse Manager jobs in Fresno, CA

Nurse Manager jobs in Washington State

Health Sciences Degree jobs in Charlotte, NC

Psychiatric Mental Health Nurse Practitioner jobs in Austin, TX

Patient Financial Specialist III

Mount Carmel -
Columbus, OH

Apply Now

Job Details

Full-time

Benefits

Relocation assistance
Health insurance
Dental insurance
Paid time off
Vision insurance
Professional development assistance
Retirement plan

Qualifications

Customer communication
Customer service
High school diploma or GED
Clinical data entry
Medical terminology
Quality data entry
Customer data entry

Full Job Description

Employment Type:
Full time

Shift:
Day Shift

Description:
Position Purpose:
The Patient Financial Specialist III performs all the functions of a PFS II. In addition, the PFS III performs verification of prior authorization and obtaining precertification for selected scheduled services. Also, this staff member is proficient in scheduling complex procedures from the physician’s office as well as complex and changing insurance/reimbursement requirements.
Location: Mount Carmel East
Unit: Radiation Oncology
Shift: Monday - Friday 7:30am - 4:00pm

Responsibilities

Performs activities that relate to patient scheduling, pre-registration, real-time eligibility verification, insurance authorization, medical order processing, medical necessity review (LMRP/LCD review), dissemination of patient information, and support coverage of other intra-departmental functions.
Determines proper scheduling requirements and/or limitations according to requested test(s)/procedure(s) and schedules resources (equipment, staff, room, and etc.) in a timely manner to ensure customer satisfaction, maintain patient flow, and appropriate utilization of the service area. Coordinates add-on and same-day appointments with the service area, as required. Ensures proper test sequencing with minimal patient delays when multiple testing is required.
Provides patient, family and physician office education during scheduling process to inform them of preparations needed for diagnostic testing and proper scheduling instructions. Communicates with various ancillary departments to ensure an accurate schedule and that all reports are properly distributed.
Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Contacts physicians/office staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s).

Requirements/Qualifications

High School Diploma
Working knowledge of medical terminology, and data entry skills. Past work experience of at least two (4) years within a physician office, hospital or clinic environment, performing patient scheduling and precertification activities is highly desired
Proven experience in 2 of the 4 following areas: Web and fax orders, Outpatient IV scheduling, Complex physician office scheduling such as Wound care and physician performed procedures, or Precertification.
Excellent interpersonal skills are necessary in dealing with peers, internal, and external customers. Accuracy, attentiveness to detail and time management skills are required.

Position Highlights and Benefits:

Mount Carmel Health System recognized by Forbes in 2025 as one of America’s Best State Employers.
Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
Retirement savings account with employer match starting on day one.
Generous paid time off programs.
Employee recognition programs.
Tuition/professional development reimbursement starting on day one.
RN to BSN tuition 100% paid at Mount Carmel’s College of Nursing.
Relocation assistance (geographic and position restrictions apply).
Employee Referral Rewards program.
Mount Carmel offers DailyPay - if you’re hired as an eligible colleague, you’ll be able to see how much you’ve made every day and transfer your money any time before payday. You deserve to get paid every day!
Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.

Ministry/Facility Information:
Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you’re seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Apply Now

Refine Your Search

rn utilization review jobs in columbus

Patient Financial Specialist III

Nurse - Skilled/Purchased Care Coordinator

Utilization Review Specialist

Denials RN Coordinator

RN, LSW, LISW, Care Manager - Columbus

Case Manager / PRN ( RN / RT / SW / LPN )

MDS Nurse Transition Leader

LPN Operations Manager - Senior Home Care

Nurse Manager (RN)

Home Health Clinical Supervisor

Appeal Analyst RN | Remote | Contract

More jobs to discover

Explore jobs in cities nearby

I want to receive the latest job alert for rn utilization review in columbus

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected