Cedars-Sinai

The Clinical Denials Management Program Coordinator RN role operates within Patient Financial Services at a nationally recognized hospital. The position manages clinically based appeals between the organization and external payers while serving as a liaison for Case Management and other departments. Key responsibilities include reviewing denials against InterQual guidelines, constructing clinically oriented appeal letters, tracking denial trends, and developing corrective action plans to reduce future denials. The role also involves providing educational sessions to staff on reimbursement changes and denial prevention strategies. This position is appealing due to the organization's reputation for excellence, its award-winning workplace culture, and a commitment to fostering a dynamic, inclusive environment. The role requires a current California RN license and significant case management experience.