Reimbursement Appeals Nurse Specialist
2 weeks ago
We are seeking a highly skilled Reimbursement Appeals Nurse to join our team at Genesis HealthCare, Inc. This role requires a strong analytical mind and excellent communication skills to effectively review patient medical records and write compelling appeal arguments.
Key Responsibilities- Conduct comprehensive analytical reviews of patient medical records to identify trends and patterns that may lead to denials.
- Write sound, sensible, and factual arguments to support payment of services provided, addressing specific reasons for denials with justification.
- Identify and report trends in charts resulting in denials, as well as regulatory changes or trends in appeal decisions that may be in breach of published regulations or payer policy guidelines.
- Participate in Administrative Law Judge hearings by providing testimony as necessary, and request additional supporting clinical evidence to support appeal arguments when existing resources are inadequate.
- Ensure compliance with HIPAA and maintain tracking records of appeals management activities in accordance with department policies.
- Provide regulatory and payer policy guidance for appeal requests at all levels, and facilitate communication with designated billing/business offices in support of Denials Management process.
- Registered Nurse with significant experience in the Healthcare Industry.
- Knowledge of regulatory requirements for reimbursement and reasons for denials.
Genesis HealthCare, Inc. is an equal opportunity employer and is committed to diversity and inclusion. We offer a competitive salary range of $80,000-$95,000 per year, and a comprehensive benefits package.
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Reimbursement Appeals Nurse Specialist
2 weeks ago
Philadelphia, Pennsylvania, United States Genesis Healthcare LLC Full timeJob Title: Reimbursement Appeals NurseGenesis Healthcare LLC is seeking a highly skilled Reimbursement Appeals Nurse to join our team. As a key member of our denial management team, you will play a critical role in conducting comprehensive analytical reviews of patient medical records and writing sound, sensible, and factual arguments to support payment of...
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Reimbursement Appeals Nurse Specialist
3 weeks ago
Philadelphia, Pennsylvania, United States Genesis Healthcare, Inc. Full timeJob SummaryWe are seeking a highly skilled Reimbursement Appeals Nurse to join our team at Genesis HealthCare, Inc. This role requires a strong analytical mind and excellent communication skills to effectively review patient medical records and write compelling appeal arguments.Key ResponsibilitiesConduct comprehensive analytical reviews of patient medical...
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Reimbursement Appeals Nurse Specialist
4 weeks ago
Philadelphia, Pennsylvania, United States Genesis Healthcare, Inc. Full timeJob SummaryWe are seeking a highly skilled Reimbursement Appeals Nurse to join our team at Genesis HealthCare, Inc.Key ResponsibilitiesConduct comprehensive analytical reviews of patient medical records to identify potential reimbursement issues.Write clear and concise appeal arguments to support payment of services provided.Identify and report trends in...
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Senior Appeals Specialist
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Clinical Reimbursement Specialist
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