Senior Denial RN Specialist

2 semanas atrás


Teresina, Brasil Ensemble Health Partners Tempo inteiro

Overview

Employer Industry: Healthcare Revenue Cycle Management

Why consider this job opportunity:

Salary range between $62,500.00 - $119,700.00 based on experience
Bonus incentives available
Paid certifications and tuition reimbursement offered
Comprehensive benefits package to support physical, emotional, and financial health
Opportunities for career advancement and professional development
Recognition programs for outstanding performance

Responsibilities
  • Review complex claims and escalate clinical or technical claim denials for appeals
  • Conduct extensive medical record reviews for medical necessity criteria and file written appeals
  • Analyze claim denials and underpayments to identify trends and potential additional payments
  • Collaborate with the Clinical Denial team and Case Management Department to communicate denial trends
  • Mentor and train Clinical Denial and Underpayment team members
Qualifications
  • Registered Nurse (RN) required
  • CRCR certification required upon hire or within 9 months
  • 5 to 7 years of relevant experience in healthcare
  • Minimum educational requirement: Associate\'s Degree or equivalent experience in Nursing
  • Must pass a typing test of 45 words per minute (error adjusted)
Preferred Qualifications
  • 4-year Bachelor\'s degree in a relevant field
  • Experience in revenue cycle, legal nurse consulting, chart audit/review, and provider relations
  • Internal candidates must have met 100% productivity and 100% Quality Assurance in the previous 3 months

#Healthcare #RevenueCycleManagement #CareerOpportunity #ProfessionalDevelopment #RemoteWork

We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.

We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.

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