A company is looking for an RN Clinical Appeals.
Key Responsibilities
Review denials and perform root cause analysis to improve processes and reduce denials
Contact insurance plans to determine reasons for claim denials and prepare necessary appeal materials
Act as a liaison between healthcare providers and ensure timely communication of denial trends and outcomes
Required Qualifications
Current unrestricted license to practice nursing (LPN, RN)
CRCR or other approved professional certification required within 9 months of hire
1 to 3 years of relevant experience
Associate's Degree or equivalent experience in Nursing
Preferred : 2 years of experience in denials, utilization review, or case management
Rn Clinical Virginia • Portland, Oregon, United States