Denials RN Coordinator (Healthcare Revenue Cycle)

Location: Remote - Nationwide, United States. Travel to and work onsite at client, temporary, or corporate offices may be required based on business needs.

Salary: $62,500–$79,800 per year, based on experience.

Company

hirify.global provides technology-enabled revenue cycle management and related solutions for hospitals, health systems, and affiliated physician groups.

What you will do

• Review complex clinical and technical claim denials and underpayments across client hospital facilities.
• Analyze medical records, medical-necessity criteria, insurance contracts, and payer medical policies.
• Prepare and submit provider, member, IRO, and ALJ appeals, including written appeal letters, corrected claims, and supporting documentation.
• Coordinate with healthcare providers, the Clinical Appeal team, and Case Management to obtain clarification and communicate denial trends and outcomes.
• Identify payment discrepancies, evaluate potential additional reimbursement, and file complaints with state Departments of Insurance when appropriate.
• Mentor and train Clinical Denial and Underpayment team members while maintaining regulatory compliance.

Requirements

• Active Registered Nurse (RN) license required.
• 5–7 years of job experience, including experience in revenue cycle, legal nurse consulting, chart audit or review, or provider relations.
• Knowledge of ERISA compliance, healthcare provider and member appeal and grievance rights, and HIPAA regulations.
• Strongly preferred: 2 years of denials, utilization review, or case management experience and a four-year bachelor's degree.
• Ability to pass a typing test at 45 error-adjusted words per minute.
• Demonstrated advanced use of AI and experience managing teams using AI to improve processes and technology.

Culture & Benefits

• Full-time employment with comprehensive healthcare, time off, retirement, and well-being benefits.
• Bonus and quarterly or annual incentive programs.
• Paid professional certifications and tuition reimbursement.
• Career advancement and professional development opportunities.
• Remote work with work-life flexibility, collaboration, innovation, and a people-focused culture.