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Senior Denials RN Specialist
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Job Description
- Req#: R037607
Employer Industry: Revenue Cycle Management
Why consider this job opportunity:
- Salary up to $79,800 based on experience
- Bonus incentives offered
- Paid certifications and tuition reimbursement available
- Comprehensive benefits package to support your health and well-being
- Opportunities for career advancement and professional growth
- Recognized as a top workplace with a focus on innovation and work-life flexibility
What to Expect (Job Responsibilities):
- Prepare appeals for clinical and technical claim denials across all client hospital facilities
- Conduct extensive reviews of medical records for medical necessity criteria and file written letters of appeal on denied claims
- Analyze claim denials and underpayments to identify potential additional payments and trends in discrepancies
- Collaborate with the Clinical Denial team and Case Management Department to communicate denial trends and outcomes
- Mentor and provide training to Clinical Denial and Underpayment team members
What is Required (Qualifications):
- Must hold a Registered Nurse (RN) license
- 5 to 7 years of relevant job experience in healthcare or revenue cycle management
- Knowledge of ERISA compliance laws and healthcare provider/member legal rights
- Must pass a typing test of 45 words per minute (error adjusted)
- Proven ability to meet productivity and quality assurance standards
How to Stand Out (Preferred Qualifications):
- Bachelor’s degree in a related field
- 2 years of experience in denials, utilization review, or case management
- 5+ years of experience in revenue cycle, legal nurse consulting, chart audit/review, or provider relations
- Internal candidates must have met 100% productivity and 100% quality assurance in the previous 3 months
#RevenueCycleManagement #HealthcareCareers #CareerOpportunity #CompetitiveBenefits #ProfessionalGrowth
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