Denial Management Nurse

The Denial Management Nurse serves as a clinical expert in denial management and avoidance, ensuring all denied claims are accurately reviewed and appropriately appealed to maximize reimbursement. This role involves collaborating with leadership and staff to improve clinical, operational, and financial outcomes while developing workflows for an in-house appeals department. The position requires analyzing claims data to identify root causes of denials and contractual underpayments, and managing work queues to ensure timely follow-up with payors.