Registered Nurse Clinical Denials Coordinator

Job Summary

A company is looking for a Clinical Denials Coordinator.

Key Responsibilities

• Report, monitor, and analyze clinical denials and coordinate appeals
• Conduct clinical appeal writing for insurance denials and evaluate patient medical records for discrepancies
• Develop training sessions and process improvement initiatives related to denial management

Required Qualifications

• Current Registered Nurse license or multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC)
• Three (3) years of healthcare clinical experience
• Bachelor's Degree in Nursing or Associate of Science in Nursing Degree; currently enrolled in a BSN program is acceptable
• Experience in Medical Management for Medicare and/or Medicaid populations is preferred
• Utilization Management experience is preferred