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Denial Analyst – RN
Franciscan Missionaries of Our Lady Health System. Handle administrative and medical appeals requiring clinical input or interpretation .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in handling administrative and medical appeals, with a focus on clinical documentation and coding accuracy. Proficient in coordinating denied claims and conducting trend analysis to improve revenue cycle management.
Highest-signal resume keywords
Clinical Documentation CoordinationClaims Denial ManagementTrend AnalysisPayer Issue ResearchRegistered Nurse License
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
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Hard Skills
Clinical Input InterpretationCoding Issue IdentificationRevenue Impact TroubleshootingAdjudication Process Management
Soft Skills
Problem SolvingCommunication
Certifications & Qualifications
Louisiana State RN License
Industry Keywords
Administrative AppealsMedical AppealsThird-Party PayersState AgenciesCorrective Action Steps
About the role
Key responsibilities & impact- Handle administrative and medical appeals requiring clinical input or interpretation
- Direct and coordinate all aspects of denied claims
- Coordinate comprehensive clinical documentation to third-party payers and state agencies to secure accurate payment
- Identify coding or clinical documentation issues
- Provide ongoing trend analysis to identify reasons for denials and apply corrective action steps
- Research and understand payer issues
- Troubleshoot and resolve issues impacting revenue
- Facilitate the internal appeal process
- Work through denied claims, gather information, and take appropriate action to ensure proper adjudication
- Utilize equipment, supplies, facilities, and resources prudently and efficiently
- Perform other duties as assigned or requested
Requirements
What you’ll need- Graduate of accredited school of nursing
- Current Louisiana State license as RN
Benefits
Comp & perks- Participation in staff educational programs
- Approved continuing education courses
- Specialized skill training programs