Virginia Licensed RN Clinical Appeals
A company is looking for an RN Clinical Appeals. Key Responsibilities Contact insurance plans to determine reasons for claim denials and analyze claims to decide if appeals are necessary Prepare appeal materials, including correcting and resubmitting claims and gathering additional medical information Collaborate with various departments to communicate denial trends and outcomes effectively Required Qualifications, Training, and Education Current unrestricted license to practice nursing (LPN, RN) CRCR or other approved professional certification required within 9 months of hire 1 to 3 years of relevant job experience Associate's Degree or equivalent experience in Nursing or a relevant discipline Preferred: 2 years of experience in denials, utilization review, or case management
A company is looking for an RN Clinical Appeals.
Key Responsibilities
Contact insurance plans to determine reasons for claim denials and analyze claims to decide if appeals are necessary
Prepare appeal materials, including correcting and resubmitting claims and gathering additional medical information
Collaborate with various departments to communicate denial trends and outcomes effectively
Required Qualifications, Training, and Education
Current unrestricted license to practice nursing (LPN, RN)
CRCR or other approved professional certification required within 9 months of hire
1 to 3 years of relevant job experience
Associate's Degree or equivalent experience in Nursing or a relevant discipline
Preferred: 2 years of experience in denials, utilization review, or case management
