RN Clinical Denial Recovery Analyst | Enterpris...
OverviewThe Clinical Denial Management Nurse is responsible for completing, tracking, and reporting clinical denials at an enterprise level across all UF hospitals. Reporting to the Enterprise Denial Nurse Manager, this role supports Revenue Cycle functions including clinical departments, finance, accounting, compliance, patient financial services, revenue integrity, managed care, utilization review, and patient access.
The Clinical Denial Management Nurse serves as a clinical expert in denial management, ensuring all denied claims are reviewed from a clinical perspective and appropriately appealed to secure maximum reimbursement and minimize organizational write-offs. ResponsibilitiesNecessary SkillsKnowledge of hospital billing and reimbursement, including Medicare/Medicaid denials, appeals, contracts, and healthcare regulationsAbility to read and interpret Explanation of Benefits (EOBs)Strong critical thinking, analytical, and problem-solving skillsHigh attention to detail with ability to work independently and accuratelyStrong organizational and time-management skillsExcellent written and verbal communication skillsProficiency in Microsoft Office (Outlook, Word, Excel)Knowledge of HIPAA guidelinesComfort working with computer systems and healthcare technology QualificationsQualificationsEducation:High School Diploma or GED requiredBSN preferredLicensure:Active RN or LPN license in the State of Florida requiredCPC, COC, RHIT, RHIA, or CCS preferredExperience:RN: 2–3 years clinical experience required ORLPN: 3–5 years clinical experience requiredCoding, medical record review, auditing, or insurance experience preferred apply to this job