Care Manager - Denials & Appeals (RN CCM)

Harris Health System, Inc. in Houston is seeking a Care Manager Clinical Denials (CM-CD) to manage clinical audits and denials related to inpatient medical necessity and coding.

You will review patient records, apply clinical and payor knowledge, and coordinate timely appeals as required. The CM-CD will serve as a liaison between Case Management and physicians, perform departmental audits to validate charging accuracy, and participate in activities to meet regulatory requirements and prevent