Overview

Johns Hopkins Medicine

  • Keswick, VA
  • Permanent
  • Full-time
Position Summary:Under general supervision of the Revenue Cycle Director of Legal Compliance and Appeals, the Sr. Appeals Nurse Specialist performs activities to ensure appropriate financial remuneration for inpatient services from third party payers. The position provides a vital link between Patient Accounting, Utilization Management, and Insurance Companies. The individual will be responsible for tracking denied inpatient claims, work with the Appeals Specialist, the Office of Managed Care, payers, outside law firms, and other sources to overturn denials on appeal and be an integral part of the effort to obtain payment for services.

Competencies:

Education:

  • Baccalaureate degree, or associate degree, or diploma in nursing from an accredited School of Nursing.

Required Licensure Certification, etc. * Requires current registered nurse licensure in the State of Maryland

Work Experience: * Five or more years related experience in a health care, health insurance industry, or professional billing area along with equivalent amount of demonstrated proficiency in developing and utilizing spreadsheets, graphics and word processing.

Full Time (40 hours)

Day Shift 8:30am to 5:00pm

Work Location: Keswick North Building

Exempt

Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

We are committed to providing a healthy and safe environment for our patients, visitors and staff members. The Johns Hopkins Hospital has a tobacco-free at work policy. Employees must refrain from using any tobacco products during their work shifts – including while at lunch or on breaks, and whether they are on or off campus.

Johns Hopkins Medicine


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