Base: $56,800.00 – $108,900.00 based on experience...
Fully remote
Current unrestricted nursing license
Proficient in microsoft suite
Experience with chart audit and review
The RN Clinical Appeals role involves analyzing claim denials, preparing appeal materials, and acting as a liaison between healthcare providers and payers
Job Summary
The RN Clinical Appeals role involves analyzing claim denials, preparing appeal materials, and acting as a liaison between healthcare providers and payers.
Ensemble Health Partners offers comprehensive benefits including tuition reimbursement, paid certifications, and bonus incentives for high performance.
Candidates must demonstrate proficiency in reviewing medical records and utilizing emerging technology to improve denial prevention processes.
Matching Summary
The RN Clinical Appeals role involves analyzing claim denials, preparing appeal materials, and acting as a liaison between healthcare providers and payers.
Salary
Base: $56,800.00 – $108,900.00 based on experience; Bonus: Incentives Paid Certifications Tuition Reimbursement; Benefits: Comprehensive Benefits Career Advancement
Skills & Requirements
Must-have
Current unrestricted nursing license
Proficient in Microsoft Suite
Experience with chart audit and review
Ability to contact insurance plans
Knowledge of medical record reviews
Nice-to-have
Demonstrated advanced usage of AI
Experience managing teams using AI
Strong provider relations skills
Background in hospital operations
Commitment to continuous innovation
Key Requirements
Current unrestricted LPN or RN license
CRCR or approved professional certification required
2 years of denials, utilization review, or case management experience preferred
Associates Degree or Equivalent required; Bachelors preferred
Willingness to travel onsite as business needs require