RN Clinical Denial Recovery Analyst | Enterprise Denials | Remote (must reside in FL, GA, PA, NC, SC, TN or TX)

UF Health • Jacksonville, FL

3h • Remote

About The Position

The Clinical Denial Management Nurse is responsible for completing, tracking, and reporting clinical denials at an enterprise level across all UF hospitals. This role supports Revenue Cycle functions including clinical departments, finance, accounting, compliance, patient financial services, revenue integrity, managed care, utilization review, and patient access. The nurse serves as a clinical expert in denial management, ensuring all denied claims are reviewed from a clinical perspective and appropriately appealed to secure maximum reimbursement and minimize organizational write-offs.

Requirements

• High School Diploma or GED required
• Active RN or LPN license in the State of Florida required
• RN: 2–3 years clinical experience required
• LPN: 3–5 years clinical experience required
• Knowledge of hospital billing and reimbursement, including Medicare/Medicaid denials, appeals, contracts, and healthcare regulations
• Ability to read and interpret Explanation of Benefits (EOBs)
• Strong critical thinking, analytical, and problem-solving skills
• High attention to detail with ability to work independently and accurately
• Strong organizational and time-management skills
• Excellent written and verbal communication skills
• Proficiency in Microsoft Office (Outlook, Word, Excel)
• Knowledge of HIPAA guidelines
• Comfort working with computer systems and healthcare technology

Nice To Haves

• BSN preferred
• CPC, COC, RHIT, RHIA, or CCS preferred
• Coding, medical record review, auditing, or insurance experience preferred

Responsibilities

• Completing, tracking, and reporting clinical denials at an enterprise level across all UF hospitals
• Supporting Revenue Cycle functions including clinical departments, finance, accounting, compliance, patient financial services, revenue integrity, managed care, utilization review, and patient access
• Serving as a clinical expert in denial management
• Ensuring all denied claims are reviewed from a clinical perspective
• Appropriately appealing denied claims to secure maximum reimbursement and minimize organizational write-offs

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees