Appeals Nurse (RN) Analyst
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Job Location:
Hanover, PA - USA
Monthly Salary:
Not Disclosed
Posted on:
2 days ago
Vacancies:
1 Vacancy
Job Summary
Position Summary:
Responsible for the timely review and resolution of clinical appeals submitted by providers and members across all lines of business. Communicates appeal determinations in accordance with regulatory requirements and serves as a clinical resource to support non-clinical staff with administrative denials and coding-related appeals. Maintains accurate tracking of appeals through logs databases and reporting tools.
Education:
Graduate of an accredited school of nursing required; BSN preferred.
Licensure/Certification:
Current Registered Nurse (RN) license in the State of Maryland required.
Experience:
Minimum of three (3) years of acute care nursing experience required. Prior experience within a health insurance or payer environment strongly preferred including case management utilization management appeals or claims processing. Experience participating in quality improvement initiatives is a plus.
Required Experience:
IC
About Company
Johns Hopkins Medicine is a leading health system and academic institution in the U.S. Find information about doctors, locations, appointments, billing, research, education and more.
