Florida Licensed Clinical Denial Analyst

Job Summary

To enhance revenue cycle performance, the full-time Florida Licensed Clinical Denial Analyst will manage clinical denials and appeals, analyze denied claims, and collaborate with various departments while working remotely.

Key Responsibilities

• Review, track, and manage clinical denials and appeals to support reimbursement optimization
• Analyze denied claims from a clinical perspective and prepare accurate, well-supported appeals
• Collaborate with cross-functional teams to resolve denial issues and identify process improvement opportunities

Required Qualifications

• High School Diploma or GED required; Bachelor's Degree in Nursing (BSN) preferred
• Licensed to practice nursing as a Registered Nurse (RN) in the State of Florida required
• Two to three years of clinical experience as a Registered Nurse (RN) required
• CPC, COC, RHIT, RHIA, or CCS certification preferred
• Knowledge of coding, medical record review, auditing, or insurance processes preferred