West Virginia RN Clinical Denials Coordinator

A company is looking for a Clinical Denials Coordinator. Key Responsibilities Report, monitor, and analyze clinical denials and coordinate appeals Evaluate patient medical records for discrepancies and negotiate billing issues with external auditors Develop training sessions and provide process improvement initiatives related to denials Required Qualifications Current unencumbered RN license in state of residency or multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) Three (3) years of healthcare clinical experience Bachelor's Degree in Nursing or Associate of Science in Nursing Degree (ASN) or Diploma; currently enrolled in a BSN program with completion within three (3) years of hire Experience in Medical Management for Medicare and/or Medicaid populations is preferred Utilization Management experience is preferred

Jun 12, 2025 - 17:30

A company is looking for a Clinical Denials Coordinator. Key Responsibilities Report, monitor, and analyze clinical denials and coordinate appeals Evaluate patient medical records for discrepancies and negotiate billing issues with external auditors Develop training sessions and provide process improvement initiatives related to denials Required Qualifications Current unencumbered RN license in state of residency or multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) Three (3) years of healthcare clinical experience Bachelor's Degree in Nursing or Associate of Science in Nursing Degree (ASN) or Diploma; currently enrolled in a BSN program with completion within three (3) years of hire Experience in Medical Management for Medicare and/or Medicaid populations is preferred Utilization Management experience is preferred