Michigan Licensed RN Coordinator

A company is looking for an RN Coordinator for Clinical Denial Recovery, full-time and remote. Key Responsibilities Specializes in follow-up of denied and rejected claims from various payers, preparing appeal letters Reviews denials for medical necessity and appealability using clinical judgment and medical necessity criteria Provides clinical utilization management expertise and facilitates denial management strategies Required Qualifications Registered Nurse with a valid, unrestricted State of Michigan License Minimum 3-5 years of clinical experience Bachelor of Science in Nursing or three years of Denial/Appeal/Utilization Management experience Knowledge of hospital billing and payer regulations Familiarity with tools/software used for patient status determination

Apr 14, 2025 - 20:28

A company is looking for an RN Coordinator for Clinical Denial Recovery, full-time and remote. Key Responsibilities Specializes in follow-up of denied and rejected claims from various payers, preparing appeal letters Reviews denials for medical necessity and appealability using clinical judgment and medical necessity criteria Provides clinical utilization management expertise and facilitates denial management strategies Required Qualifications Registered Nurse with a valid, unrestricted State of Michigan License Minimum 3-5 years of clinical experience Bachelor of Science in Nursing or three years of Denial/Appeal/Utilization Management experience Knowledge of hospital billing and payer regulations Familiarity with tools/software used for patient status determination