Clinical Denial Analyst (RN)

About the role

This role involves managing assigned denials—such as those related to no authorization, medical necessity, and readmissions—in accordance with policies and productivity standards. The coordinator collaborates with third-party payors to secure payment using proper collection techniques and maintains accounts receivable goals.

Responsibilities

• Prepare appeals for denials.
• Report denial activities and identify trends to aid the Denial Analysis Team in implementing preventative measures.

Requirements

• Active RN licensure in Indiana or a compact state.
• At least two years of experience in utilization review, charge audit, or case management within an acute or specialty hospital.

Qualifications

• Preferred: BSN degree.
• Preferred: Three to five years of clinical RN experience.

Skills

• Knowledge of healthcare resources, utilization management, and case management.

Schedule

Full-time position within the HRS department, focusing on denial management and revenue cycle support.