Registered Nurse (RN) - Denial and Appeals - Clinical Resource Management
Employment type
Full-time
Work setting
On-site
Location
Wallingford, CT
Schedule
Day shift
Posted
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Job overview
The Denial and Appeals Registered Nurse (RN) is an onsite role based in Wallingford, CT, supporting the Clinical Resource Management department. Compensation is not specified for this full-time position within the Hartford HealthCare network. The role focuses on managing the payer denial and appeals process, ensuring regulatory compliance, and collaborating with medical directors to formulate clinical appeals. The Registered Nurse (RN) works autonomously to manage complex cases and identify denial trends to support performance improvement.
What you'll do
- Manage denials and appeals, ensure regulatory compliance, collaborate with stakeholders, partner with medical directors on appeal letters, maintain documentation, analyze root causes, and provide education on mitigation strategies.
What we're looking for
- Skills & competencies
- full-timeday shiftwallingford cthartford healthcareregistered nurserndenial and appealscase managementutilization managementno on-callno weekends
- Work arrangement
- Weekend coverage required
Benefits & perks
- Competitive benefits program, career development opportunities, service recognition programs.
Why this role
Physician-led, clinically integrated network; focus on high-volume complex case management.
About the employer
Hartford HealthCare Corp. is hiring for this role. Industry: Offices of Physicians (except Mental Health Specialists). Sector: 62.
Additional details
- Industry sector
- 62
- Industry
- Offices of Physicians (except Mental Health Specialists)
- Occupation code
- 29-1141.00
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Listing ID: 9972562d-d410-4f67-b9a0-ebe54b079461