Ensemble Health Partners
Senior Denials RN Specialist
6 days agoWhat's your preference?
Job Description
- Req#: R040089
Employer Industry: Revenue Cycle Management Solutions
Why consider this job opportunity:
- Salary range between $62,500.00 - $79,800.00 based on experience
- Bonus incentives available
- Paid certifications and tuition reimbursement provided
- Comprehensive benefits package supporting physical, emotional, and financial health
- Opportunity for career advancement and professional development
- Recognized as a top workplace for remote work flexibility
What to Expect (Job Responsibilities):
- Review complex claims and escalate clinical or technical claim denials for potential appeals
- Conduct extensive reviews of medical records for medical necessity criteria and file appeal letters on denied claims
- Analyze claim denials and underpayments to identify trends and determine additional payment amounts
- Collaborate with the Clinical Denial team and Case Management Department to communicate denial trends and outcomes
- Mentor and train Clinical Denial and Underpayment team members
What is Required (Qualifications):
- Legally required: Registered Nurse (RN) license
- Minimum of 5 to 7 years of relevant experience
- Must pass a typing test of 45 words per minute (error adjusted)
- Experience in revenue cycle, legal nurse consulting, chart audit/review, and provider relations
- Internal candidates must have met 100% productivity and 100% quality assurance in the previous 3 months
How to Stand Out (Preferred Qualifications):
- Bachelor’s degree
- 2 years of experience in denials, utilization review, or case management strongly preferred
#RevenueCycleManagement #HealthcareCareers #RemoteWork #CareerAdvancement #TopWorkplace
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Ensemble Health Partners is the leading revenue cycle management company for hospitals. We build relationships & find the best solutions to your challenges.
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