Nurse Coordinator – PreServices

Trinity Health

. Plan and provide professional nursing services in accordance with nursing standards, education, experience, Ohio nursing requirements, and established policies .

Posted 10/8/2026full-timeRemote • Ohio • United StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in nursing services, denial management, and regulatory compliance, with a strong focus on optimizing revenue and preventing denials. Proficient in medical terminology, coding, and collaboration with healthcare providers to ensure appropriate care and authorizations.

Highest-signal resume keywords

Valid Ohio RN LicenseDenial Management ExperienceMedical Record Coding (ICD-10, CPT/HCPCS)Knowledge of Insurance RegulationsExperience with Epic Prelude and Resolute

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Nursing ServicesDenial InvestigationMedical Necessity ReviewsRevenue OptimizationRegulatory Policy ApplicationCoding ExperienceInsurance AuthorizationCase ManagementUtilization ManagementRoot Cause Analysis

Soft Skills

CollaborationCommunicationProblem-SolvingEducation and Training

Tools & Technologies

Epic PreludeEpic Resolute

Certifications & Qualifications

AAPC CertificationAHIMA CertificationHFMA CertificationAAHAM CertificationNAHAM Certification

Industry Keywords

MedicareMedicaidManaged Care ContractsBilling ProcessesEligibility Issues

About the role

Key responsibilities & impact

Plan and provide professional nursing services in accordance with nursing standards, education, experience, Ohio nursing requirements, and established policies
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
Collaborate with physician providers to align proposed service intensity with severity of illness and support level-of-care determinations and authorizations
Investigate denials and root causes
Track and report denial trends to support remediation and internal process improvement
Research and apply regulatory policies to support administrative appeals
Coordinate denial management processes, including administrative/technical accounts and operational write-offs
Track initial denials and collaborate with Patient Access and Revenue Cycle colleagues on education and stakeholder reporting
Maintain required competencies, licenses, and certifications and support the learning and development of others

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, eligibility issues, and no authorization
Experience with medical terminology
Medical record coding experience, 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 of 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, allowing eligible colleagues to transfer earned pay before payday
Diversity, Equity, and Inclusion Colleague Resource Groups