Appeals Nurse - Technical Analyst

MedStar Health; Baltimore (MD); Remote; Full time

Job summary

Join a leading healthcare provider as a Technical Nurse Analyst, working remotely in Maryland. You will manage clinical appeal resolutions, collaborating with billing teams to ensure effective communication and analysis. Enjoy a competitive benefits package and be part of a dynamic team committed to patient care and healthcare excellence.

Benefits

Full medical, dental, and vision plans

Paid time off (PTO)

Tuition reimbursement

Employee Referral Program Bonus

Qualifications

• 3 years of acute care nursing experience.
• 1 year in processing administrative and clinical appeals.
• Ability to communicate effectively with clinical teams.

Responsibilities

• Resolve clinical appeals from billing denials.
• Track appeals using logs and databases.
• Assist in review of accounts for coding edits.

Skills

Communication

Clinical Appeals Management

Data Analysis

Education

Baccalaureate degree or diploma in nursing

Registered Nurse licensed in Maryland

Job description

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Job Details

Requisition #: 654836
Location: Johns Hopkins Health System,
Baltimore,
MD 21201

Category: Nursing
Schedule: Day Shift
Employment Type: Full Time

You Belong Here! Come see why the Johns Hopkins Health System is a world-renowned leader in patient care, serving the greater Baltimore community and patients from all across the globe. Our friendly and knowledgeable staff teams provide support throughout our many specialty departments and centers, from primary visits to emergency care.

Take a tour of our campus:

https://www.youtube.com/watch?v=KnNaPzR-AEE

This is a remote position. Our organization is registered for remote work in the following states: MD, VA, DC, FL, PA, and DE.

What You Wil Do:

Reporting to the Revenue Cycle Manager, Technical Billing, the Technical Nurse Analyst is primarily responsible for timely resolution of clinical appeals received as the result of line-item denials from the Patient Financial Services Billing teams. This position will need to be able to effectively communicate resolution to appellant while providing resources to non-clinical staff in review of administrative denials or appeals involving coding disputes. The Technical Nurse Analyst will also produce Epic reports and analyze data to determine with the Senior Billing Specialist, Patient Financial Reporting Analyst, and Revenue Cycle Manger, Technical Billing which accounts need to be appealed based on past data and clinical documentation.

Critical to this position is the ability to track appeals on logs, databases, and other data as deemed appropriate. Incumbent will also serve as a preceptor, resource, advisor, and a leader to the other members of the clinical Appeals staff and the technical billing team. The Technical Nurse Analyst will also assist with review of accounts for coding edits as needed.

What Awaits You:

Our competitive Benefit Package is designed to support the well-being and financial security of our employees and includes:

• Full medical, dental, and vision plans,
• Retirement plans,
• Paid time off (PTO),
• Tuition reimbursement for you and your dependents,
• Earn up to $1,000 annually for practicing self-care with Healthy @ Hopkins
• Tell a friend and get paid! Ask about our Employee Referral Program Bonus!
• And more! Visit https://jhh.mybenefitsjhhs.com/

Who Should Apply:

Requirements:

• Baccalaureate degree, or associate degree, or diploma in nursing from an accredited School of Nursing.
• Registered Nurse licensed in the state of Maryland or compact license.
• Three (3) years of acute care nursing experience and a minimum of one (1) year in the health care environment processing both administrative and clinical appeals.

Salary Range: Minimum 42.34/hour - Maximum 65.62/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility.

In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins!

Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

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