RN Denials Specialist

Thank you for considering a career at Ensemble Health Partners!

The Clinical Denials Nurse is responsible for:

• Identifying the root cause for clinical claim denial

• Reviewing medical records against nationally recognized clinical criteria guidelines (Interqual, MCG, NCD/LCD,DCA, etc.)

• Using clinical decision making to determine the appropriate actions needed to recover or defend revenue

• Writing professional appeals in response to denied claims or payer audit requests

•  Identifying and reporting trends to remediate issues and assist with internal process improvement

Minimum Requirements:

• Active RN or LPN license required

• 2+ years of experience in an acute care hospital direct patient care setting required

• Case Management or Utilization Review experiences strongly preferred

• Understanding of Revenue Cycle including admission, billing, payments and denials preferred

• Knowledge of patient insurance process and requirements preferred  

#LI-JC1

#LI-REMOTE

Scheduled Weekly Hours:

Work Shift:

We’ll also reward your hard work with:

• Great health, dental and vision plans
• Prescription drug coverage
• Flexible spending accounts
• Life insurance w/AD&D
• Paid time off
• Tuition reimbursement
• And a lot more

Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact our Human Resources Department at 877-692-7780 or [email protected].  This department will make sure you get connected to a Human Resources representative that can assist you.​

EEO is the Law
FMLA Rights - English

La FMLA Español