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