Denial Prevention Nurse Consultant - Remote
5 days ago

Job summary
We are seeking a Denial Prevention Nurse Consultant to join our team at Revecore. As a Denial Prevention Nurse Consultant, you will be responsible for thorough review of medical records and other medical documentation to determine appropriate billable services for hospital construction an appeal for payment based on medical necessity or payer specific guidelines or criteria.- Analyze medical records or other medical documentation to validate services tests supplies and drugs performed for accuracy related to billing for services rendered
- Identify and interpret medical radiological laboratory or other tests and procedures as well as pharmaceutical drugs
- Review and understand managed care contracts hospital billing statements bills insurance denials research commercial governmental payor policies clinical abstracts studies other documentation related claims payment evaluate appeal denied claims.
Job description
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