Licensed Nurse Consultant

To optimize clinical denials operations, the full-time Licensed Nurse Consultant will coordinate case study presentations, provide onboarding and mentoring for new hires, and participate in the quality assurance process while working remotely. Key Responsibilities Coordinate Clinical Case Study presentations and manage communications at the Nurse Consultant level Provide onboarding, training, and mentoring to new nurse hires Participate in the quality assurance process to ensure compliance with guidelines and deadlines Required Qualifications Licensed RN with a college degree or diploma from a nursing school Minimum 5 years of experience in denials and appeals or hospital revenue cycle Clinical nursing experience in a hospital environment, preferably in ER, ICU, Med-Surg, or Transplant unit Familiarity with MCG, InterQual, NCD/LCDs, and payor medical policies Moderate computer proficiency with Microsoft Office applications