RN Clinical Financial Case Manager II – Denials & Pre-Cert

Inside Higher Ed; Columbus (OH); On-site; USD 65,000 - 85,000; Full time

Job summary

A prominent medical institution in Columbus, Ohio is seeking a Clinical Financial Case Management - RN Specialist 2. This role involves implementing clinical pre-certification, managing denials, and supporting patient care teams. Candidates must possess a Bachelor's degree in nursing, a current RN license, and at least 3 years of clinical experience. Strong analytical and communication skills are essential along with proficiency in various software applications. The position is full-time with a regular schedule and first shift hours.

Qualifications

• Current RN license required.
• Minimum of 3 years clinical care experience with patient care.
• Experience collaborating with physicians.

Responsibilities

• Implement and support the values and procedures of the Medical Center.
• Secure complex pre-authorizations and manage clinical denials.
• Interpret medical necessity guidelines for patient services.

Skills

Analytical skills

Clinical operations knowledge

Microsoft Office proficiency

Communication skills

Problem-solving

Education

Bachelor’s degree in nursing

Tools

IHIS

Adobe Professional

MS Office products

Job description

A prominent medical institution in Columbus, Ohio is seeking a Clinical Financial Case Management - RN Specialist 2. This role involves implementing clinical pre-certification, managing denials, and supporting patient care teams. Candidates must possess a Bachelor's degree in nursing, a current RN license, and at least 3 years of clinical experience. Strong analytical and communication skills are essential along with proficiency in various software applications. The position is full-time with a regular schedule and first shift hours.