Job Summary
A company is looking for a Senior Denial RN Specialist who prepares appeals for clinical and technical claim denials across various client hospital facilities.
Key Responsibilities
- Review complex claims and escalate clinical or technical claim denials for potential appeals
- Analyze medical records and prepare documentation for appeals, ensuring timely submission
- Mentor and provide training to Clinical Denial and Underpayment team members
Required Qualifications, Training, and Education
- Registered Nurse (RN) required
- CRCR certification required within 9 months of hire
- 5 to 7 years of relevant experience
- Associate's Degree in Nursing or equivalent experience required
- Preferred: Bachelor's degree in a relevant field
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