What are the responsibilities and job description for the Denial Nurse position at CallTek?
Staff4Me is currently seeking a skilled and motivated Denial Nurse to join our team. As a Denial Nurse, you will play a crucial role in the healthcare revenue cycle management process by reviewing and appealing denied insurance claims. If you have a strong background in nursing and a passion for ensuring fair reimbursement for healthcare services, we would love to hear from you.
Responsibilities- Review and manage denied insurance claims, working to resolve issues and ensure proper reimbursement
- Review denied insurance claims and determine the appropriate course of action
- Analyze medical records and documentation to support claim appeals
- Communicate with insurance companies, healthcare providers, and patients to gather necessary information for claim appeals
- Prepare appeal letters and supporting documents to effectively argue for claim payment
- Stay up-to-date with insurance policies and regulations to ensure accurate claim appeals
- Collaborate with the billing and coding team to identify potential coding or documentation issues that may contribute to claim denials
- Maintain detailed records and documentation of claim appeals and outcomes
- Participate in training sessions and educational programs to enhance knowledge of denial management
- Registered Nurse (RN) license
- Previous experience in denial management, medical billing, or related field
- Strong knowledge of insurance policies, coding guidelines, and claim appeal processes
- Excellent analytical and problem-solving skills
- Effective communication and negotiation abilities
- Detail-oriented with strong organizational skills
- Ability to work independently and prioritize tasks
- Proficient in medical terminology and medical record documentation
- Experience with electronic health records (EHR) and medical billing software
- Commitment to maintaining patient confidentiality and privacy
