Registered Nurse Clinical Denials Specialist
A company is looking for a Clinical Denials Specialist to manage claim denials related to referrals, authorizations, and medical necessity. Key Responsibilities Research and manage assigned payer denials and prepare professional appeal letters Prepare reports for management, identifying trends and opportunities for process improvement Monitor denial and appeal outcomes, ensuring compliance with regulations and reporting findings to management Required Qualifications Associate's Degree in a business or healthcare-related field Registered Nurse (RN) Certification with relevant experience Experience with Electronic Health Records (EHR) platforms Knowledge of various insurance payers preferred Proficient PC knowledge and ability to type 30-40 wpm
A company is looking for a Clinical Denials Specialist to manage claim denials related to referrals, authorizations, and medical necessity.
Key Responsibilities
Research and manage assigned payer denials and prepare professional appeal letters
Prepare reports for management, identifying trends and opportunities for process improvement
Monitor denial and appeal outcomes, ensuring compliance with regulations and reporting findings to management
Required Qualifications
Associate's Degree in a business or healthcare-related field
Registered Nurse (RN) Certification with relevant experience
Experience with Electronic Health Records (EHR) platforms
Knowledge of various insurance payers preferred
Proficient PC knowledge and ability to type 30-40 wpm
