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Clinical Denials and Appeals RN - Springfield Massachusetts

Company: VirtualVocations
Location: Springfield, Massachusetts
Posted On: 11/15/2024

A company is looking for a Clinical Denials and Appeals RN - Remote.

Key Responsibilities

Conduct medical necessity reviews and ensure documentation integrity
Construct warranted appeals and coordinate pre-service authorization approvals
Perform comprehensive denial root-cause analysis and retrospective medical record reviews

Required Qualifications

Current Registered Nursing License
Bachelor's Degree or equivalent
Minimum of 4-6 years clinical experience
Clinical denials experience required
Utilization review experience is a plus More...

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