Washington RN Denial Reviewer

A company is looking for an RN Denial Reviewer for a remote full-time position. Key Responsibilities Perform in-depth reviews of clinical DRG downgrade denials and draft appeal letters for payers Develop and maintain clinical denial processes, templates, and best practices for documentation Educate providers and caregivers on documentation needs to mitigate denials and improve accuracy Required Qualifications Education from an accredited School of Nursing or a Doctor of Medicine Minimum of 5 years of experience as a Clinical Documentation Specialist in a hospital setting Registered Nurse license or Certified Clinical Documentation Specialist credential required Preferred experience with 3M 360 Encompass, CAC, and Epic software Knowledge of Medicare guidelines and clinical documentation integrity programs preferred

Mar 12, 2025 - 00:23

A company is looking for an RN Denial Reviewer for a remote full-time position. Key Responsibilities Perform in-depth reviews of clinical DRG downgrade denials and draft appeal letters for payers Develop and maintain clinical denial processes, templates, and best practices for documentation Educate providers and caregivers on documentation needs to mitigate denials and improve accuracy Required Qualifications Education from an accredited School of Nursing or a Doctor of Medicine Minimum of 5 years of experience as a Clinical Documentation Specialist in a hospital setting Registered Nurse license or Certified Clinical Documentation Specialist credential required Preferred experience with 3M 360 Encompass, CAC, and Epic software Knowledge of Medicare guidelines and clinical documentation integrity programs preferred