RN Denial Mitigation & Appeals – Remote Eligible

Baptist Memorial Health Care Corporation; Memphis (TN); Híbrido; USD 65.000 - 90.000; Jornada completa

Descripción de la vacante

Baptist Memorial Health Care Corporation is seeking an experienced RN to support denial mitigation and appeals within our revenue cycle. The specialist reviews clinical records, prepares timelines and appeals, and collaborates with physicians and payers to optimize reimbursement.

The role emphasizes strong communication, analytical skills, and knowledge of payer guidelines to defend claims and drive favorable outcomes. Remote work may be possible after onboarding and meeting productivity goals.

Formación

• RN with at least 5 years of clinical experience in acute care.
• 3–5 years of insurance provider or medical review experience preferred.
• Experience with denial management, authorizations, and appeals.

Responsabilidades

• Review clinical information and documentation for appeals and downgrades.
• Prepare clinical timelines and summaries to support post-claim denials.
• Collaborate with physician advisors, coding/billing, and payers.
• Submit retro-authorization requests, reconsiderations, and appeals.

Conocimientos

RN

Denial management

Payer knowledge

Communication skills

Analytical thinking

Educación

Graduate of an accredited nursing program

Herramientas

Electronic Medical Records (EMR) systems

Descripción del empleo

Baptist Memorial Health Care Corporation is seeking an experienced RN to support denial mitigation and appeals within our revenue cycle. The specialist reviews clinical records, prepares timelines and appeals, and collaborates with physicians and payers to optimize reimbursement.

The role emphasizes strong communication, analytical skills, and knowledge of payer guidelines to defend claims and drive favorable outcomes. Remote work may be possible after onboarding and meeting productivity goals.