Ohio Licensed Clinical Appeals Manager

Job Summary

A company is looking for a Manager of Clinical Appeals.

Key Responsibilities

• Oversee daily operations of clinical appeals and denial analysis, resolution, and prevention
• Lead staff in analyzing and resolving third-party payer denials and drive denial prevention efforts
• Develop and implement policies, procedures, and workflows to improve operational efficiency

Required Qualifications

• Bachelor's degree in nursing with a current license; advanced degree preferred
• Minimum of 5 years clinical care experience and 8 years in denials and appeals
• Five years of management experience in denials and appeals
• Extensive knowledge of clinical operations and patient flow
• Proficient in Microsoft Office and various technology applications