Clinical Resource Management Denials Coordinator (RN)

Marshall Health Network • Huntington, WV

1d

About The Position

Cabell Huntington Hospital is seeking a full-time Denials Coordinator (RN) to
work alongside our Clinical Resource Management Department.

The Denial Coordinator exercises independent judgment and professional
discretion in the practice of case management to a select group of patients.
They collaborate with URS and physicians to ensure that patients are at the
appropriate level of care with the use of clinical based guidelines such as
InterQual.  The Denial Coordinator provides necessary documentation for appeal
of denials and provides updates to the billing department of the denial/appeal
statuses. They utilize collaborative problem solving skills to meet the needs of
the patients and physician while meeting the contractual guidelines of our
payers.

Requirements

• Bachelor’s degree in Nursing required.
• 5+ Years of Position-Related Experience required.
• Clinical expertise in area of responsibility and management of patients in designated area
• Utilization management principles including but not limited to insurance authorizations, denial management, appeal management
• Excellent verbal and written communication skills
• Builds effective relationships with the healthcare team
• Demonstrates critical thinking skills
• Clinical and leadership skills, performance improvement, DRG’s, analytical skills.

What This Job Offers

• Job Type: Full-time