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