Senior Denial Rn Specialist

Há 4 dias


Barueri, Brasil Ensemble Health Partners Tempo inteiro

OverviewEmployer Industry: Healthcare Revenue Cycle ManagementWhy consider this job opportunity:Salary range between $62,500.00 - $119,700.00 based on experienceBonus incentives availablePaid certifications and tuition reimbursement offeredComprehensive benefits package to support physical, emotional, and financial healthOpportunities for career advancement and professional developmentRecognition programs for outstanding performanceResponsibilitiesReview complex claims and escalate clinical or technical claim denials for appealsConduct extensive medical record reviews for medical necessity criteria and file written appealsAnalyze claim denials and underpayments to identify trends and potential additional paymentsCollaborate with the Clinical Denial team and Case Management Department to communicate denial trendsMentor and train Clinical Denial and Underpayment team membersQualificationsRegistered Nurse (RN) requiredCRCR certification required upon hire or within 9 months5 to 7 years of relevant experience in healthcareMinimum educational requirement: Associate\'s Degree or equivalent experience in NursingMust pass a typing test of 45 words per minute (error adjusted)Preferred Qualifications4-year Bachelor\'s degree in a relevant fieldExperience in revenue cycle, legal nurse consulting, chart audit/review, and provider relationsInternal candidates must have met 100% productivity and 100% Quality Assurance in the previous 3 months#Healthcare #RevenueCycleManagement #CareerOpportunity #ProfessionalDevelopment #RemoteWorkWe prioritize candidate privacy and champion equal-opportunity employment.
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