Denial Prevention Nurse Consultant

About the Role

Join Revecore as a Denial Prevention Nurse Consultant in United States. Start your next chapter at Revecore! For over 25 years, Revecore has been at the forefront of specialized claims management, helping healthcare providers recover meaningful revenue to enhance quality patient care in their communities.

Key Responsibilities

• must be RN * Clinical nursing experience working in hospital environment, preferably in ER, Critical Care or diagnostic services * Minimum 5 years of related experience and/or training in utilization review or patient accounting * Are highly proficient with Interqual and MCG guidelines and demonstrate appropriate application to claim appeal argument.

• provide best practice recommendations to clients and Revecore managers.

• Lead client meetings and perform consulting services to client's as it relates to medical necessity of se.

Requirements

• Are highly proficient with Interqual and MCG guidelines and demonstrate appropriate application to claim appeal argument.

• Understand patient accounting documents

• Have a working knowledge of Microsoft Office (Word, Excel, Outlook)

• Possess technical proficiency to work on multiple computer screens and software applications simultaneously

Benefits & Compensation

• We offer paid training and incentive plans

• Our medical, dental, vision, and life insurance benefits are available from the first day of employment

• We enjoy excellent work/life balance

• Our Employee Resource Groups build community and foster a culture of belonging and inclusion

Work Schedule

• Full-time position.

• No explicit call, weekend, or night shift information provided.

Apply to join Revecore as a Denial Prevention Nurse Consultant.