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Clinical Finance Case Manager - RNVirtualVocations • Largo, Florida, United States
Clinical Finance Case Manager - RN

Clinical Finance Case Manager - RN

VirtualVocations • Largo, Florida, United States
3 days ago
Job type
  • Full-time
Job description
To support the Revenue Cycle Clinical Support team, the full-time Clinical Finance Case Manager - RN will manage complex pre-authorizations and clinical denials while working remotely, utilizing clinical knowledge to interpret medical necessity guidelines and collaborating with multidisciplinary teams. Key responsibilities Implement and support clinical pre-certification, case reviews, and denial management processes Determine appropriate levels of care by interpreting clinical information and payer guidelines Act as a Subject Matter Expert for assigned payers and maintain awareness of healthcare trends and compliance requirements Required qualifications Bachelor's degree in nursing with a current license Minimum of 2 years of clinical care experience Experience collaborating with physicians and understanding care plans Strong analytical skills and ability to synthesize large volumes of information Proficiency in Microsoft Office and various technology applications
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Clinical Finance Case Manager - RN • Largo, Florida, United States

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