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Michigan Licensed RN Coordinator
Job Summary
A company is looking for an RN Coordinator for Clinical Denial Recovery, full-time and remote.
Key Responsibilities
- Specializes in follow-up of denied and rejected claims from various payers, preparing appeal letters
- Reviews denials for medical necessity and appealability using clinical judgment and medical necessity criteria
- Provides clinical utilization management expertise and facilitates denial management strategies
Required Qualifications
- Registered Nurse with a valid, unrestricted State of Michigan License
- Minimum 3-5 years of clinical experience
- Bachelor of Science in Nursing or three years of Denial/Appeal/Utilization Management experience
- Knowledge of hospital billing and payer regulations
- Familiarity with tools/software used for patient status determination
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COMPLETE JOB DESCRIPTION
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