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.

Responsibilities

• Review and manage denied insurance claims, working to resolve issues and ensure proper reimbursement
• Review denied insurance claims and determine the appropriate course of action
• Analyze medical records and documentation to support claim appeals
• Communicate with insurance companies, healthcare providers, and patients to gather necessary information for claim appeals
• Prepare appeal letters and supporting documents to effectively argue for claim payment
• Stay up-to-date with insurance policies and regulations to ensure accurate claim appeals
• Collaborate with the billing and coding team to identify potential coding or documentation issues that may contribute to claim denials
• Maintain detailed records and documentation of claim appeals and outcomes
• Participate in training sessions and educational programs to enhance knowledge of denial management

Requirements

• Registered Nurse (RN) license
• Previous experience in denial management, medical billing, or related field
• Strong knowledge of insurance policies, coding guidelines, and claim appeal processes
• Excellent analytical and problem-solving skills
• Effective communication and negotiation abilities
• Detail-oriented with strong organizational skills
• Ability to work independently and prioritize tasks
• Proficient in medical terminology and medical record documentation
• Experience with electronic health records (EHR) and medical billing software
• Commitment to maintaining patient confidentiality and privacy