Clinical Denial Specialist, RN

northside· Care Coordination
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📍 Atlanta, GA, USFULL TIME

About this role

Overview

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

Responsibilities

Processes, tracks and appeals clinical denials. Supports and facilitates the design, development and implementation of Utilization Management data collection methodologies and studies in the respective functional areas. Displays and analyzes data to identify trends. Works collaboratively to develop plan of action.

Qualifications

REQUIRED:

Case Management:

 

1. Graduate of an accredited school of nursing, with strong clinical case management experience

2. Three (3) years experience in Utilization Management/Case Management or related field,

 

with specific experience in the following areas: the application of industry prevalent guideline criteria; knowledge of coding, billing, audit and reimbursement payer methodologies and guidelines. Experience in the collection, interpretation, and presentation of data to medical staff members; and, interaction with managed care companies, including appealing denials. 

Work Hours:

8am- 4:30pm

Weekend Requirements:

No

On-Call Requirements:

No

Frequently Asked Questions

Is the salary disclosed for the Clinical Denial Specialist, RN position at northside?
The salary for this Clinical Denial Specialist, RN role at northside is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Where is the Clinical Denial Specialist, RN position at northside located?
This Clinical Denial Specialist, RN role at northside is based in Atlanta, GA, US. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Clinical Denial Specialist, RN role at northside full-time or part-time?
This is listed as a FULL TIME position. It is posted as a Clinical Denial Specialist, RN role in the Care Coordination department at northside.
Which team or department does the Clinical Denial Specialist, RN at northside belong to?
This Clinical Denial Specialist, RN position is part of the Care Coordination department at northside. See the full job description for more information about the team structure and responsibilities.
How do I apply for the Clinical Denial Specialist, RN position at northside?
Click the "Apply Now" button on this page. You will be redirected to northside's official application portal hosted on icims where you can submit your application directly.
When was the Clinical Denial Specialist, RN job at northside posted?
This Clinical Denial Specialist, RN position at northside was posted on Apr 24, 2026. Apply as soon as possible — early applications are often reviewed first.
Clinical Denial Specialist, RN
northside
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