Denial Nurse

Staff4Me is currently seeking a skilled and motivated Denial Nurse to join our team. As a Denial Nurse, you will play a crucial role in the healthcare revenue cycle management process by reviewing and appealing denied insurance claims. If you have a strong background in nursing and a passion for ensuring fair reimbursement for healthcare services, we would love to hear from you.ResponsibilitiesReview and manage denied insurance claims, working to resolve issues and ensure proper reimbursementReview denied insurance claims and determine the appropriate course of actionAnalyze medical records and documentation to support claim appealsCommunicate with insurance companies, healthcare providers, and patients to gather necessary information for claim appealsPrepare appeal letters and supporting documents to effectively argue for claim paymentStay up-to-date with insurance policies and regulations to ensure accurate claim appealsCollaborate with the billing and coding team to identify potential coding or documentation issues that may contribute to claim denialsMaintain detailed records and documentation of claim appeals and outcomesParticipate in training sessions and educational programs to enhance knowledge of denial management

RequirementsRegistered Nurse (RN) licensePrevious experience in denial management, medical billing, or related fieldStrong knowledge of insurance policies, coding guidelines, and claim appeal processesExcellent analytical and problem-solving skillsEffective communication and negotiation abilitiesDetail-oriented with strong organizational skillsAbility to work independently and prioritize tasksProficient in medical terminology and medical record documentationExperience with electronic health records (EHR) and medical billing softwareCommitment to maintaining patient confidentiality and privacy