Clinical Resource Manager & Appeals Coordinator

Rumcsi; New York (NY); On-site; USD 85,878 - 98,116; Part time

Job summary

Rumcsi in New York is searching for a Clinical Resource Manager Coordinator to support revenue cycle initiatives through the management of denial cases. The ideal candidate will hold a Bachelor's degree and be a registered nurse in New York.

This role involves analyzing denial patterns, coordinating patient care, and collaborating with interdisciplinary teams. Requires a minimum of 5 years clinical experience and supervisory skills. A strong understanding of documentation and patient care processes is essential.

The salary range is $62.339/hr - $71.223/hr, commensurate with experience.

Qualifications

• Current registration in New York State as an RN, Diploma and Licensure required.
• PRI and Screen certificate required.
• At least 5 years of clinical experience required.

Responsibilities

• Act as a resource to Case Managers regarding denial of payments.
• Maintain payer database and update reports as necessary.
• Analyze denials and appeals for patterns and trends.

Skills

Clinical experience as a Registered Nurse

Supervisory experience with utilization review/management

Knowledge of Microsoft Word and Excel

Interqual knowledge/experience

SAVVY, Invision, RAX experience

Education

Bachelor's degree

Masters Degree preferred

Job description

Rumcsi in New York is searching for a Clinical Resource Manager Coordinator to support revenue cycle initiatives through the management of denial cases. The ideal candidate will hold a Bachelor's degree and be a registered nurse in New York.

This role involves analyzing denial patterns, coordinating patient care, and collaborating with interdisciplinary teams. Requires a minimum of 5 years clinical experience and supervisory skills. A strong understanding of documentation and patient care processes is essential.

The salary range is $62.339/hr - $71.223/hr, commensurate with experience.