Medasource
Senior Healthcare Recruiter at Medasource | Scaling Healthcare Organizations with High-Impact Revenue Cycle Talent
RN Denials Manager
Fully Remote
Equipment Provided
We are seeking an experienced
RN Denials Manager
to lead a centralized clinical denials review team for a large multi-state health system. This leader will oversee RN Denials/Audit Specialists responsible for reviewing medical necessity denials, coordinating appeals, and evaluating case documentation to support maximum reimbursement and high-quality patient care outcomes.
This is a
hands‑on leadership role
with direct oversight of team performance, operational workflow, payer‑related escalation support, and staff development.
Schedule:
Monday–Friday, 8:00 AM–4:30 PM (AZ Time)
Key Responsibilities
Lead daily operations of clinical denials review team; manage workflow and queue assignments
Review medical necessity denials and support clinical appeal documentation
Collaborate closely with Utilization Review, Case Management, and Physician Advisors
Act as clinical subject matter expert for denial resolutions and case review standards
Coach, develop, and mentor direct reports; support growth, training, and onboarding
Monitor trends, identify payer patterns, and recommend process improvements
Ensure compliance with internal review policies and payer requirement
Required Qualifications
Active RN license (any state where residing)
5+ years
of RN experience
2+ years
of leadership experience with direct reports
Experience in
clinical denials management / appeals / utilization review
Familiarity with payer approval criteria and reimbursement processes
Bachelor’s degree preferred (BSN strongly encouraged)
Preferred Experience
Hospital or health system background
Prior experience managing centralized denial review teams
Strong clinical documentation review and medical necessity appeal writing
Details
Fully remote
(must reside in an approved state)
Laptop/equipment provided
Competitive hourly rate
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Hospitals and Health Care
#J-18808-Ljbffr
Fully Remote
Equipment Provided
We are seeking an experienced
RN Denials Manager
to lead a centralized clinical denials review team for a large multi-state health system. This leader will oversee RN Denials/Audit Specialists responsible for reviewing medical necessity denials, coordinating appeals, and evaluating case documentation to support maximum reimbursement and high-quality patient care outcomes.
This is a
hands‑on leadership role
with direct oversight of team performance, operational workflow, payer‑related escalation support, and staff development.
Schedule:
Monday–Friday, 8:00 AM–4:30 PM (AZ Time)
Key Responsibilities
Lead daily operations of clinical denials review team; manage workflow and queue assignments
Review medical necessity denials and support clinical appeal documentation
Collaborate closely with Utilization Review, Case Management, and Physician Advisors
Act as clinical subject matter expert for denial resolutions and case review standards
Coach, develop, and mentor direct reports; support growth, training, and onboarding
Monitor trends, identify payer patterns, and recommend process improvements
Ensure compliance with internal review policies and payer requirement
Required Qualifications
Active RN license (any state where residing)
5+ years
of RN experience
2+ years
of leadership experience with direct reports
Experience in
clinical denials management / appeals / utilization review
Familiarity with payer approval criteria and reimbursement processes
Bachelor’s degree preferred (BSN strongly encouraged)
Preferred Experience
Hospital or health system background
Prior experience managing centralized denial review teams
Strong clinical documentation review and medical necessity appeal writing
Details
Fully remote
(must reside in an approved state)
Laptop/equipment provided
Competitive hourly rate
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Hospitals and Health Care
#J-18808-Ljbffr