Ohio RN Clinical Finance Specialist

Job Summary

Ohio RN Clinical Finance Specialist is a full-time remote position responsible for implementing clinical finance strategies, securing pre-authorizations, and managing clinical denials.

Key Responsibilities

• Implement and support clinical finance strategies to secure pre-authorizations and manage clinical denials
• Collaborate with multidisciplinary teams to interpret medical necessity guidelines and determine appropriate levels of care
• Maintain expertise in payer requirements and assist in audits and compliance processes

Required Qualifications

• Bachelor's degree in nursing with a current license
• Minimum of 2 years clinical care experience
• Experience collaborating with physicians and understanding patient care plans
• Strong analytical skills and ability to synthesize large volumes of information
• Proficient in Microsoft Office and various technology applications