Appeals Nurse - Technical Analyst (654836)

Johns Hopkins Medicine; Baltimore (MD); Remote; USD 100,000 - 125,000; Full time

Job summary

Join a leading healthcare system as a Technical Nurse Analyst, focusing on resolving clinical appeals from billing teams. This remote position offers opportunities for data analysis, collaboration, and leadership within the appeals team, ensuring timely resolution of claims and enhancing patient financial services.

Benefits

Full medical, dental, and vision plans

Retirement plans

Paid time off (PTO)

Tuition reimbursement for employees and dependents

Self-care reimbursement up to $1,000 annually

Referral bonus through Employee Referral Program

Qualifications

• At least three years of acute care nursing experience.
• One year in healthcare processing administrative and clinical appeals.
• Effective communication and data analytics skills required.

Responsibilities

• Responsible for resolving clinical appeals and administrative denials.
• Analyze data, produce Epic reports, and track appeals.
• Serve as a resource and preceptor for clinical Appeals staff.

Skills

Communication

Data Analysis

Leadership

Education

Baccalaureate degree in nursing from an accredited School of Nursing

Registered Nurse license in Maryland

Job description

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 Will Do:

Reporting to the Revenue Cycle Manager, Technical Billing, the Technical Nurse Analyst is responsible for the timely resolution of clinical appeals resulting from line-item denials from the Patient Financial Services Billing teams. The role requires effective communication of resolutions to appellants and providing resources to non-clinical staff reviewing administrative denials or appeals involving coding disputes. The analyst will produce Epic reports and analyze data to identify accounts needing appeals, collaborating with the Senior Billing Specialist, Patient Financial Reporting Analyst, and Revenue Cycle Manager, Technical Billing.

The position also involves tracking appeals on logs, databases, and other appropriate data systems. The analyst will serve as a preceptor, resource, advisor, and leader within the clinical Appeals staff and technical billing team. Additionally, they will assist with reviewing accounts for coding edits as needed.

What Awaits You:

Our competitive Benefit Package supports employee well-being and financial security, including:

• Full medical, dental, and vision plans
• Retirement plans
• Paid time off (PTO)
• Tuition reimbursement for employees and dependents
• Up to $1,000 annually for practicing self-care with Healthy @ Hopkins
• Referral bonus through our Employee Referral Program
• And more! Visit https://jhh.mybenefitsjhhs.com/

Who Should Apply:

Requirements:

• Baccalaureate degree, associate degree, or diploma in nursing from an accredited School of Nursing
• Registered Nurse license in Maryland or a compact license
• At least three (3) years of acute care nursing experience and one (1) year in healthcare processing administrative and clinical appeals

Salary Range: $42.34/hour (minimum) - $65.62/hour (maximum). Compensation is based on experience and equity for similar roles.

Salary details may be discussed during screening if the range is not specified.

Johns Hopkins prioritizes the health and well-being of its employees. Come be healthy at Hopkins!

Diversity and Inclusion are core values. We are committed to creating an inclusive environment where all employees feel valued, contribute to our mission, and receive equitable healthcare and workforce practices.

Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, genetic information, veteran status, or other protected statuses.

We are a drug-free workplace employer.