Clinical Appeals Registered Nurse

A company is looking for a Clinical Denials and Appeals RN. Key Responsibilities Secure pre-service approvals and review pre/post service denials Conduct comprehensive denial root-cause analysis and retrospective medical record reviews Coordinate pre-service authorization approvals and construct warranted appeals Required Qualifications Bachelor's Degree (relevant experience may substitute formal education) Current Registered Nursing License Minimum of 4-6 years of prior clinical experience Familiarity with medical records assembly and clinical terminology Working knowledge of basic coding guidelines

Feb 13, 2025 - 18:19
 0
Clinical Appeals Registered Nurse
A company is looking for a Clinical Denials and Appeals RN. Key Responsibilities Secure pre-service approvals and review pre/post service denials Conduct comprehensive denial root-cause analysis and retrospective medical record reviews Coordinate pre-service authorization approvals and construct warranted appeals Required Qualifications Bachelor's Degree (relevant experience may substitute formal education) Current Registered Nursing License Minimum of 4-6 years of prior clinical experience Familiarity with medical records assembly and clinical terminology Working knowledge of basic coding guidelines