RN Nurse Consultant

To support hospitals in enhancing patient care, the full-time remote RN Nurse Consultant will analyze medical records for billing accuracy, identify trends in revenue cycle issues, and provide best practice recommendations to clients. Key responsibilities Analyze medical documentation to validate services and prepare appeals for denied claims Identify fail points in the revenue cycle and provide remediation recommendations to clients Maintain communication with payors and clients regarding claims status and resolve underpayments or denials Required qualifications RN with a college degree or diploma from a nursing school Minimum 5 years of experience in utilization review or patient accounting Clinical nursing experience in a hospital setting, preferably in ER or Critical Care Proficiency with Interqual and MCG guidelines for claim appeals Familiarity with healthcare billing software and patient accounting documents (UB04, EOB)