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Registered Nurse or Physical Therapist Denials Management Specialist


Pay$65000.00 - $88600.00 / year
LocationCharleston/South Carolina
Employment typeFull-Time

This job is now closed

  • Job Description

      Req#: R-380899
      Employer Industry: Home Health Care

      Why consider this job opportunity:
      - Salary up to $88,600 per year
      - Health benefits effective day 1, including medical, dental, and vision coverage
      - Generous paid time off, holidays, and jury duty pay
      - 401(k) retirement savings plan with employer match and tuition assistance
      - Career development opportunities and support for personal wellness
      - Flexible work arrangements with occasional travel for training or meetings

      What to Expect (Job Responsibilities):
      - Respond to, manage, and monitor all payer requests for additional documentation, appeals, and denials
      - Collaborate with branch staff to gather required information and ensure timely responses to payer requests
      - Construct responses to denials and appeals, utilizing applicable federal guidelines
      - Monitor and interpret federal and governmental regulations, disseminating relevant information
      - Provide trended reports for operations and clinical management to improve performance

      What is Required (Qualifications):
      - Current state license as a Registered Nurse or Physical Therapist
      - Minimum of 5 years of professional experience in Home Care, with at least 2 years in an administrative, supervisory, quality assurance, or teaching position in a Medicare certified home health agency
      - Thorough knowledge of federal regulations and Medicare requirements
      - Extensive knowledge of home care operations, compliance requirements, and legal issues
      - Excellent written and verbal communication skills

      How to Stand Out (Preferred Qualifications):
      - Extensive experience working with payer requirements, including traditional Medicare and Medicare Advantage plans
      - Ability to learn Homecare Homebase and the Waystar system quickly
      - Highly flexible and motivated, able to work independently and in a team setting
      - Proven ability to work under pressure and manage multiple tasks effectively

      #HomeHealthCare #HealthcareJobs #CareerDevelopment #CompetitiveBenefits #RemoteWorkOpportunity

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  • About the company

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