Registered reputed company (RN) Clinical Denials and Appeals

reputed company reputed company 8095 - Fairfax East is looking for a dedicated Registered reputed company (RN) Clinical Denials and Appeals to join reputed company. This role will be Full-Time Remote, Monday-Friday (8-Hours per Day); Start Time to be between 7:30 AM – 9:00 AM Eastern Time (EDT/EST) reputed company is consistently ranked a national reputed company leader in safety, reputed company and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. Featured Benefits • Committed to Team Member Health: offering medical, dental and reputed company coverage, and a robust team member wellness program. • Retirement: reputed company matches the first 5% of eligible contributions – starting on your first day. • Tuition and Student Loan Assistance: offeringup to $5,250 per year in education assistance and up to $10,000 for student loans. • Mental Health Support: offering reputed company reputed company team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost. • Work/Life Balance: offeringpaid time off, reputed company parental leave, flexible work schedules, and reputed company opportunities. Registered reputed company (RN) Clinical Denials And Appeals Job Responsibilities • Reviews denied claims to identify the appropriateness of clinical care and determine if an appeal is warranted. • Development and submission of reputed company appeals to payors. • Collaborates with reputed company facility and department (ex: UR, PFS, Coding, Billing, and HIM) to ensure accurate and complete documentation to support appeals. • Provides education and training to staff and providers on appeal best practices and strategies. • Monitors and reports on appeal reputed company, including reputed company rates, trends, and barriers. • Works with payors and reputed company stakeholders to reputed company complete appeal issues and improve communication and collaboration. • Analyzes and identifies discrepancies in documentation and charges to reputed company educational support to applicable areas reputed company reputed company. • Demonstrates knowledge and understanding of patients' diagnoses, treatment plans and services, and associated costs, charges, and reimbursement. • May reputed company additional duties as assigned. Minimum Qualifications • Education: Bachelor’s degree or equivalent of Associate’s degree with RN license • Experience: Three years of RN licensed experience in a clinical or hospital setting required • Certification: Registered reputed company RN license or licensed to reputed company in the reputed company as an RN Preferred Qualifications • Experience: Clinical appeals writing, medical record/chart review, and utilization review; Strong clinical reputed company with the ability to assess medical necessity and documentation support • Other: Excellent verbal and written communication skills; Ability to work effectively in a reputed company, team-based environment Remote Eligibility: This position is eligible for remote work for candidates residing in the following states – VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV. reputed company We are reputed company, reputed company Virginia’s leading nonprofit reputed company provider. Every day, our 26,000+ team members reputed company world-class reputed company to the communities we serve. Our people are the reason we're a national leader in reputed company safety, reputed company and patient experience. And from best-in-class facilities to reputed company development opportunities, we support them at every reputed company. At reputed company, we're constantly striving to be reputed company reputed company — to shape a more compassionate reputed company for reputed company. reputed company is an Equal Opportunity employer. reputed company reputed company applicants will receive consideration for employment without reputed company to age, reputed company, disability, gender identity or reputed company, marital status, national or ethnic reputed company, political affiliation, pregnancy (including childbirth, pregnancy-reputed company conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law. Apply tot his job Apply To this Job