Job Summary
A healthcare consulting company has a current position open for a Remote Denials Nurse Specialist.
Core Responsibilities Include:
- Identifying the root cause for clinical claim denial
- Writing professional appeals in response to denied claims or payer audit requests
- Reviewing medical records against nationally recognized clinical criteria guidelines
Applicants must meet the following qualifications:
- Active RN or LPN license required
- 2+ years of experience in an acute care hospital direct patient care setting required
- Experience identifying and reporting trends to remediate issues and assist with internal process improvement
