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Clinical Denials Nurse
at Ensemble Health Partners
Cincinnati, OH

Clinical Denials Nurse
at Ensemble Health Partners
Cincinnati, OH

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Ensemble Health Partners

Thank you for considering a career at Ensemble Health Partners!

Clinical Denials Nurse – RN Clinical Denials

At Ensemble Health Partners, we are seeking active, engaged, and enthusiastic team members who are nurses and want to work closely with patients and care givers in a non-clinical role. A Clinical Denials Nurse is a vital member of the healthcare team, and is responsible for providing world class service to clients.

Clinical Denials Nurse Responsibilities include:

The Clinical Denials Nurse performs all clinical denials activities across Ensemble Health Partners. Job duties include but are not limited to, identifying the root cause for clinical claim denial, reviewing medical records against nationally recognized clinical criteria guldens (Interqual, MCG, NCD/LCD,DCA, etc.), using clinical decision making to determine the appropriate actions needed to recover or defend revenue, writing professional appeals in response to denied claims or payer audit requests, and identifying and reporting trends to remediate issues and assist with internal process improvement.

Clinical Denials Nurse will receive benefits:

    • Competitive compensation and benefits packages that reflect our commitment to providing fair and just workplaces.
    • Wellness programming designed to help our associates enhance their health, including a comprehensive annual health risk assessment.
    • A culture truly participatory and to strengthen diversity and inclusion.
    • Growth-Once you've joined our team, you will discover a variety of traditional and online learning opportunities, including tuition reimbursement, to help you acquire new skills and obtain degrees, certifications and CEUs. And our managers will coach you toward greater success.
    • Recognition-We recognize our associates through programs that include service awards, celebrations and personal appreciation. We also survey associates annually to assess their satisfaction with our organization and managers, and to identify areas for improvement.

Clinical Denials Nurse Requirements include:

    • Active RN or LPN license in the state of Ohio required
    • 2+ years of experience in an acute care hospital direct patient care setting required
    • Case Management or Utilization Review experiences strongly preferred
    • Understanding of Revenue Cycle including admission, billing, payments and denials preferred
    • Knowledge of patient insurance process and requirements preferred

We'll also reward your hard work with:

    • Great health, dental and vision plans
    • Prescription drug coverage
    • Flexible spending accounts
    • Life insurance w/AD&D
    • Paid time off
    • Tuition reimbursement
    • And a lot more

Scheduled Weekly Hours: 40

Work Shift:

Days/Afternoons (United States of America)

Ensemble Health Partners is an equal opportunity employer.

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