Travel RN - Case Management/Utilization Review - Case Management

American Traveler is hiring an experienced RN for a Clinical Denials Specialist (Case Manager) position requiring Epic proficiency, clinical appeal letter writing experience, and a FL or Compact RN license.Job Details• Hospital-based Case Management/Utilization Review setting within a Revenue Cycle environment,• Primary focus on clinical denial management, including reviewing denied accounts and submitting clinical appeals,• Day shift, 5x8-hour shifts (8:00 AM - 5:00 PM),• Epic EMR used; experience required,• No telemetry or bedside patient care responsibilities - this is a desk-based denials and appeals role,Job Requirements• Active FL or Compact RN license currently in hand,• Current BLS (AHA or ARC) and ACLS required; NIH Stroke Scale certification also required,• Minimum of 2 years of recent, consecutive clinical or case management experience within the past 24 months in a US hospital,• Degree from an accredited nursing school, or from an institution approved by the Florida Board of Nursing (FBON) with 2 years of recent acute care experience,• Clinical appeal letter writing experience required,• Epic EMR experience required, with demonstrated expertise in Revenue Cycle,• Case management experience highly preferred,Additional Information• Responsible for conducting comprehensive reviews of denied accounts, writing compelling clinical appeal letters, and submitting appeals to payers in a timely manner,• Manages a work queue of accounts receivable and sets follow-up activities based on claim status,• Researches payer denials related to referrals, eligibility, pre-authorization, non-covered expenses, and billing issues,• Remains current on CMS guidelines, payer-specific policies, contracts, and administrative bulletins,• Communicates identified payer denial trends to relevant stakeholders,• Smoke-free facility,• COVID vaccination documentation required - declinations are not accepted,