Job Summary

A non-profit healthcare system has an open position for a Remote Registered Nurse Appeals Denial Specialist in Halethorpe.

Core Responsibilities Include:

• Appealing denials of days of care and/or patient care services
• Resolving denial issues that can be managed successfully without appeal
• Reviewing admissions and service requests within assigned unit

Required Skills:

• Graduate of a Registered Nursing Program and Active RN License
• Five years’ clinical experience required; Med/Surg and/or ICU preferred
• Knowledge of insurance regulations/contracts, managed care, CMS, and ER Autopay desired
• Auditing experience is required