Remote Jobs
Denials Management RN Specialist Remote
This job is now closed
Job Description
- Req#: 25017450
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work remotely from anywhere within the continental U.S.
- Comprehensive benefits from day one, including mental health resources and support
- Engaging work environment focused on community and holistic well-being
- Chance to make a significant impact on clinical services and patient reimbursement processes
What to Expect (Job Responsibilities):
- Investigate and appeal post-remit denials for all Inpatient and Outpatient clinical services
- Review and correct charge errors while adhering to compliance regulations
- Research information to determine the appropriateness of appeals and conduct account history research
- Collaborate with various departments to gather necessary patient information for the appeals process
- Provide reports and training on identified clinical denial trends and recommend remediation strategies
What is Required (Qualifications):
- Bachelor’s degree
- Minimum of 1+ years of related experience
- Registered Nurse (RN) license
- Extensive understanding of CPT, HCPCS, ICD, UB-04 Revenue Codes, and billing regulations
- Strong written communication skills to craft individualized appeal letters
How to Stand Out (Preferred Qualifications):
- Master's degree
- Certified Case Manager (CCM) certification
- Certified Clinical Documentation Specialist (CCDS) certification
- Accredited Case Manager (ACM) certification
#HealthcareServices #RemoteWork #CareerGrowth #ClinicalDenialManagement #HealthcareCareers
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