RN Clinical Denial Recovery Analyst | Enterprise Denials | Remote (must reside i
UF Health, Jacksonville, FL, United States
Overview
The Clinical Denial Management Nurse is responsible for completing, tracking, and reporting clinical denials at an enterprise level across all UF hospitals. Reporting to the Enterprise Denial Nurse Manager, this role supports Revenue Cycle functions including clinical departments, finance, accounting, compliance, patient financial services, revenue integrity, managed care, utilization review, and patient access.
The Clinical Denial Management Nurse serves as a clinical expert in denial management, ensuring all denied claims are reviewed from a clinical perspective and appropriately appealed to secure maximum reimbursement and minimize organizational write-offs.
Necessary Skills
Knowledge of hospital billing and reimbursement, including Medicare/Medicaid denials, appeals, contracts, and healthcare regulations
Ability to read and interpret Explanation of Benefits (EOBs)
Strong critical thinking, analytical, and problem-solving skills
High attention to detail with ability to work independently and accurately
Strong organizational and time-management skills
Excellent written and verbal communication skills
Proficiency in Microsoft Office (Outlook, Word, Excel)
Knowledge of HIPAA guidelines
Comfort working with computer systems and healthcare technology
Qualifications
Education:
High School Diploma or GED required
BSN preferred
Licensure:
Active RN or LPN license in the State of Florida required
CPC, COC, RHIT, RHIA, or CCS preferred
Experience:
RN: 2–3 years clinical experience required
OR
LPN: 3–5 years clinical experience required
Coding, medical record review, auditing, or insurance experience preferred
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The Clinical Denial Management Nurse is responsible for completing, tracking, and reporting clinical denials at an enterprise level across all UF hospitals. Reporting to the Enterprise Denial Nurse Manager, this role supports Revenue Cycle functions including clinical departments, finance, accounting, compliance, patient financial services, revenue integrity, managed care, utilization review, and patient access.
The Clinical Denial Management Nurse serves as a clinical expert in denial management, ensuring all denied claims are reviewed from a clinical perspective and appropriately appealed to secure maximum reimbursement and minimize organizational write-offs.
Necessary Skills
Knowledge of hospital billing and reimbursement, including Medicare/Medicaid denials, appeals, contracts, and healthcare regulations
Ability to read and interpret Explanation of Benefits (EOBs)
Strong critical thinking, analytical, and problem-solving skills
High attention to detail with ability to work independently and accurately
Strong organizational and time-management skills
Excellent written and verbal communication skills
Proficiency in Microsoft Office (Outlook, Word, Excel)
Knowledge of HIPAA guidelines
Comfort working with computer systems and healthcare technology
Qualifications
Education:
High School Diploma or GED required
BSN preferred
Licensure:
Active RN or LPN license in the State of Florida required
CPC, COC, RHIT, RHIA, or CCS preferred
Experience:
RN: 2–3 years clinical experience required
OR
LPN: 3–5 years clinical experience required
Coding, medical record review, auditing, or insurance experience preferred
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