Denials Rn Coordinator

Ensemble Health Partners

Multiple Locations, US
$62,500.00 - $79,800.00/ based on experience; bonu...
Fully remote
Understanding insurance contract terms
Analyzing medical records
Understanding payer medical policy guidelines
Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, offering end-to-end solutions and point solutions

Job Summary

  • Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, offering end-to-end solutions and point solutions.
  • The Denials RN Coordinator prepares appeals for clinical and technical claim denials, analyzes medical records, and ensures compliance with HIPAA and ERISA.
  • The company offers bonus incentives, paid certifications, tuition reimbursement, comprehensive benefits, and career advancement opportunities.

Matching Summary

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, offering end-to-end solutions and point solutions.

Salary

$62,500.00 - $79,800.00/ based on experience; Bonus Incentives; Comprehensive Benefits

Skills & Requirements

Must-have

  • understanding insurance contract terms
  • analyzing medical records
  • understanding payer medical policy guidelines
  • preparing IRO appeal documentation
  • submitting provider, member and IRO/ALJ appeals
  • reviewing claim denials and underpayments

Nice-to-have

  • customer obsession
  • embracing new ideas
  • striving for excellence
  • human touch
  • challenging the status quo

Key Requirements

  • Registered Nurse RN license
  • 5 to 7 years job experience
  • 2 years denials, utilization review, or case management experience
  • 45 words per minute typing speed
  • 5+ Years Revenue Cycle experience
  • 5+ Years Legal nurse consulting experience
  • 5+ Years Chart audit/review experience
  • 5+ Years Provider relations experience
  • Demonstrated advanced usage of AI

Work Rights

Not specified

Tailored Resume

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