Job Summary
A healthcare company is in need of a Remote Care Management Denial and Appeals Administrator Registered Nurse.
Core Responsibilities of this position include:
- Assessing, planning, coordinating and evaluating initial and ongoing denial activity
- Obtaining information on all denials occurring as related to observation and inpatient stays
- Researching and responding to denials in a timely fashion
Must meet the following requirements for consideration:
- Requires Bachelor’s Degree in Nursing or related field
- Minimum 5 years or more related experience preferably in a healthcare case management and patient insurance/billing environment
- Comprehensive knowledge of clinical documentation and medical coding
- Working knowledge of patient financial billing regulations/requirements, reimbursement, managed car
- Comprehensive understanding of medical records coding, patient billing policies and procedures and health insurance standards
