Imperial is currently seeking a Registered Nurse with 2 to 3 years of clinical nursing background and 2 to 3 years of Utilization Review experience. The ideal nurse for this role would also be proficient in conducting peer-to-peer meetings, mitigation of denials, have a strong understanding of the preauthorization process, the revenue cycle, reducing financial risk, be able to liaise with providers/staff, and work with payers while having regulatory awareness.
About the Role
The UM Denials Specialist, RN will be responsible for managing the denials process and ensuring compliance with medical necessity criteria.
Responsibilities
Qualifications
Required Skills
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