New York Licensed Denials Clinician

Job Summary

A company is looking for a Clinician, Denials Management - Remote.

Key Responsibilities

• Maintain the integrity of information in appeals and ensure medical accuracy in written appeals
• Research payer denials and make recommendations for workflow revisions to improve efficiency
• Review payor communications and identify risks for reimbursement loss, escalating issues as necessary

Required Qualifications

• 4-year degree required
• Must be a Registered Nurse with clinical experience
• Experienced in medical chart review and hospital nursing
• Basic knowledge of MS Excel and ability to learn proprietary databases
• Must be goal-oriented and able to meet ongoing deadlines