Rn Clinical Appeals

Ensemble Health Partners

Multiple Locations, US
$56,800.00 – $108,900.00; bonus incentives; compre...
Fully remote
Clinical appeals review
Root cause analysis
Medical records review
The RN Clinical Appeals performs all appeals for clinically related claim denials across Ensemble Health Partners, or in a role that primarily assists with analyzing and reviewing records to prevent future denials, provide clinical records to payers, and prepare for provider-to-provider (P2P) reviews

Job Summary

  • The RN Clinical Appeals performs all appeals for clinically related claim denials across Ensemble Health Partners, or in a role that primarily assists with analyzing and reviewing records to prevent future denials, provide clinical records to payers, and prepare for provider-to-provider (P2P) reviews.
  • This position pays between $56,800.00 – $108,900.00 based on experience and offers bonus incentives, paid certifications, tuition reimbursement, comprehensive benefits, and career advancement.
  • Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, recognized for its commitment to empowering people and fostering a culture of collaboration, growth, and innovation.

Matching Summary

The RN Clinical Appeals performs all appeals for clinically related claim denials across Ensemble Health Partners, or in a role that primarily assists with analyzing and reviewing records to prevent future denials, provide clinical records to payers, and prepare for provider-to-provider (P2P) reviews.

Salary

$56,800.00 – $108,900.00; Bonus Incentives; Comprehensive Benefits

Skills & Requirements

Must-have

  • Clinical Appeals Review
  • Root Cause Analysis
  • Medical Records Review
  • Liaison with Payers
  • Timely Appeal Submission

Nice-to-have

  • Customer Obsession
  • Embracing New Ideas
  • Striving for Excellence
  • AI Exploration and Application

Key Requirements

  • Current unrestricted nursing license (LPN, RN)
  • CRCR or approved professional certification within 9 months
  • 1-3 Years Job Experience
  • 2 years denials, utilization review, or case management experience strongly preferred
  • Proficient computer skills, Microsoft Suite

Work Rights

Not specified

Tailored Resume

Cover Letter