Denials Manager RN

The Denials Case Manager, RN appeals all denials using InterQual criteria and medical necessity. Collaboratively works with all members of the revenue cycle team and all types of payers to resolve denials, maximize accurate and timely reimbursement, and perform reimbursement recovery and retention service. Evaluates, tracks and trends denials, and implements denial prevention programs. Works in collaboration with Case Managers, Physicians, Finance and multidisciplinary teams to ensure compliance with documentation and educates as needed.