Nurse Coordinator, PreServices

Trinity Health

. Review pre/post service initial denials .

Posted 10/9/2026full-timeColumbus • Ohio • United StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in denial management processes, including clinical knowledge of medical necessity and eligibility issues, while effectively collaborating with healthcare teams to optimize revenue and prevent denials. Proficient in applying regulatory policies and medical coding standards to support administrative appeals and process improvements.

Highest-signal resume keywords

Registered Nurse (RN) LicenseDenial ManagementMedical Record Coding (ICD-10, CPT/HCPCS)Insurance Knowledge (Medicare, Medicaid)Epic Prelude and Resolute

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Denial InvestigationClinical KnowledgeRegulatory Policy ApplicationRevenue OptimizationMedical Necessity ReviewTechnical Accounts ManagementAdministrative AppealsRoot Cause AnalysisProcess ImprovementMedical Terminology

Soft Skills

CollaborationCommunicationEducationProblem-SolvingStakeholder Reporting

Tools & Technologies

Epic PreludeEpic Resolute

Certifications & Qualifications

AAPC CertificationAHIMA CertificationHFMA CertificationAAHAM CertificationNAHAM Certification

Industry Keywords

Managed Care ContractsPatient AccessMid-Revenue CycleDenial PreventionEligibility Issues

About the role

Key responsibilities & impact

Review pre/post service initial denials
Secure escalated insurance authorizations
Handle escalated medical necessity reviews
Coordinate with Patient Access, Mid-Revenue Cycle, and Patient Business Service to identify revenue optimization and denial prevention opportunities
Work with physician providers to align proposed intensity of service with severity of illness and support level-of-care determinations and required authorizations
Investigate denials and root causes
Track and report denial trends to support remediation and internal process improvement
Apply clinical knowledge and standard procedures to address denials timely
Research and apply regulatory policies to support administrative appeals
Coordinate denial management processes, including administrative/technical accounts and operational write-offs
Collaborate with Patient Access and Revenue Cycle colleagues on education and reporting to stakeholders

Requirements

What you’ll need

Graduation from an accredited school of nursing
Valid Ohio RN license
1-2 years' experience of technical and/or clinical denials, including medical necessity and eligibility issues
Experience with medical terminology
Experience with medical record coding, including ICD-10 and CPT/HCPCS
Knowledge of insurance and governmental programs, regulations, and billing processes, including Medicare, Medicaid, managed care contracts, and coordination of benefits
Bachelor’s degree preferred
Certification and/or membership in AAPC, AHIMA, HFMA, AAHAM, or NAHAM preferred
Working knowledge of Epic Prelude and Resolute preferred
Knowledge and experience in case management/utilization management and managed care contracts preferred

Benefits

Comp & perks

Medical, dental, and vision coverage starting on day one
Retirement savings account with employer match starting on day one
Generous paid time off programs
Employee recognition programs
Tuition/professional development reimbursement starting on day one
RN to BSN tuition 100% paid at Mount Carmel’s College of Nursing
Relocation assistance (geographic and position restrictions apply)
Employee Referral Rewards program
DailyPay access for eligible colleagues
Diversity, Equity, and Inclusion Colleague Resource Groups