Massachusetts RN Denial Administrator
Company: VirtualVocations
Location: Virginia Beach
Posted on: February 20, 2025
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Job Description:
A company is looking for an RN Denial and Appeal
Administrator.
Key Responsibilities
Manage the psychiatric pre-denial, denial, and appeal processes
Utilize medical necessity screening tools for patient care
evaluations
Collaborate with payers to secure authorization for clinical
services
Required Qualifications
Nursing degree: Diploma, ASN, or BSN (preferred); ability to obtain
BSN within 4 years
Valid MA RN License
CCM or ACM certification preferred
5 years of experience in Case Management and HMO settings
Comprehensive knowledge of clinical documentation and medical
coding
Keywords: VirtualVocations, Virginia Beach , Massachusetts RN Denial Administrator, Healthcare , Virginia Beach, Virginia
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