Denials and Appeals Manager (RN required)
Company: Atlas Search
Location: Bronx
Posted on: April 17, 2024
|
|
Job Description:
The Denials and Appeals Manager will be responsible for
overseeing the denials and appeals process to ensure timely and
accurate resolution of claim denials and disputes. This RN manager
will work closely with the billing department, healthcare
providers, and insurance companies to identify and address denials,
file appeals, and advocate for the reimbursement of denied claims.
The ideal candidate will have a background in nursing, experience
in insurance, and expertise in utilization review.*Key
Responsibilities:** Manage the denials and appeals process for all
denied claims, including reviewing denial reasons, gathering
necessary documentation, and preparing appeals.* Analyze denial
trends and identify opportunities for process improvement to
prevent future denials.* Collaborate with healthcare providers,
including physicians, nurses, and other clinical staff, to gather
supporting documentation for appeals.* Communicate with insurance
companies and third-party payers to negotiate claim resolutions and
ensure timely payment.* Monitor the status of appeals and provide
regular updates to stakeholders on progress and outcomes.* Serve as
a subject matter expert on insurance regulations, coverage
policies, and reimbursement guidelines.* Develop and implement
training programs for staff on denials management best practices
and appeal strategies.* Maintain accurate records of denials,
appeals, and outcomes for reporting and auditing
purposes.*Requirements:** Active Registered Nurse (RN) license in
the state of New York.* Bachelor's degree in Nursing or related
field preferred.* Minimum of 2 years of experience working in
healthcare, with a focus on denials management, appeals, or
utilization review.* Strong understanding of insurance billing,
reimbursement, and claims processing.* Excellent analytical and
problem-solving skills, with the ability to identify root causes of
denials and implement effective solutions._Please note- The annual
base salary range is $100k to $110k. Actual compensation offered to
the successful candidate may vary from posted hiring range based
upon geographic location, work experience, education, and/or skill
level, among other things. Details about eligibility for bonus
compensation (if applicable) will be finalized at the time of
offer.__-__Atlas Search is a tri-state area recruitment agency,
connecting new graduates, Advanced Practice Providers, Physicians
and Nurse Leaders to hospitals, clinics, multi-specialty groups,
nursing homes, managed care companies, private practices, and
healthcare start-ups. __If you would like to learn more about the
opportunities we offer, please submit your CV for consideration
here._#IndeedHCJob Type: Full-timePay: $100,000.00 - $110,000.00
per yearBenefits:* 401(k)* 401(k) matching* Dental insurance*
Health insurance* Life insurance* Paid time off* Tuition
reimbursement* Vision insuranceSchedule:* 8 hour shiftWork
setting:* In-personApplication Question(s):* What is the best phone
number and email address to reach you?Experience:* denials
management, appeals, or utilization review: 2 years
(Required)License/Certification:* RN License (Required)Ability to
Relocate:* Bronx, NY: Relocate before starting work (Required)Work
Location: In person
Keywords: Atlas Search, Mount Vernon , Denials and Appeals Manager (RN required), Healthcare , Bronx, New York
Click
here to apply!
|