Clinical Appeals Specialist, RN

Remote Full-time
Overview:**
Xtend Healthcare is seeking a Clinical Appeals Specialist, RN to work collaboratively with project leaders and clients to assist healthcare providers in evaluating, reporting, and providing recommendations on denied or underpaid claims. This remote position requires a registered nurse with five years of experience in utilization review and electronic health record expertise... **Responsibilities:**
Ā• Evaluate, report findings, and provide recommendations on denied or underpaid claims
Ā• Assist in identifying, complying, and reversing denials from payers
Ā• Work closely with client departments to review and obtain medical documentation for denial appeals
Ā• Compile, analyze, and report on data related to underpayments, denials, revenue opportunities, and revenue leakage
Ā• Serve as a resource for billing and reimbursement questions requiring clinical knowledge and medical records review and interpretation
Ā• Continuously review and update knowledge of relevant regulations
Ā• Perform other duties as assigned related to clinical review and patient care management
Ā• *Qualifications:**
Ā• Bachelor's degree in Nursing, Business, Health Information, Clinical Studies, or Registered Nurse (RN) from an accredited institution
Ā• Five years' experience as an RN, including utilization review experience
Ā• Electronic health record (EHR) expertise, including knowledge of various vendors
Ā• Reliable high-speed internet, cell phone, and computer equipment
Ā• Private workspace or home office free from distractions
Ā• *Benefits:**
Ā• Competitive salary and benefits package
Ā• Opportunity to work with a leading revenue cycle management company
Ā• Collaborative and dynamic work environment
Ā• Professional development and growth opportunities
Ā• Comprehensive training program
Ā• Equal Opportunity Employer with a commitment to diversity and inclusion

Apply Now

For more such jobs please click here!
Apply Now →

Similar Jobs

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote

USPS Office Helper

Remote

[Remote] Freelance US Sales Recruiter (Remote, Part-Time)

Remote

Experienced Full Stack Customer Support Specialist – Live Chat & Remote Work Opportunities at careerzynith

Remote

Total Rewards Associate

Remote

**Experienced Customer Service Agent – Remedy On-Call (Part Time) Supporting Physician Practices**

Remote

Spacecraft Mechanical Production Engineer

Remote

Oncology Account Executive

Remote

Revenue Requirement Analyst (Mid-Level / Associate) Portland, OR in Portland, OR

Remote

Supervisory Audiologist

Remote

ICFProgram Manager – Diversity, Equity, and Inclusion (DEI) – Remote inReston, Virginia

Remote

Want Restaurant Team Member - Crew (1957 - Beverly_MA) in Beverly, MA

Remote
← Back