RN Clinical Denials Case Manager
Fort Lauderdale, Florida
Broward Health Corporate

Job Opportunity: Case Manager (Registered Nurse)

Location: Fort Lauderdale, Florida
Employment Type: Travel/Contract
Contract Length: 13 weeks

Job Description

• Role: Clinical Denials Specialist (Case Manager)
• Responsibilities:

  • Manage clinical denial accounts by reviewing denied claims and writing appeal letters based on documentation and payer policies.
  • Resolve denials to recover outstanding accounts receivable by understanding denial reasons and researching internal/external policies.
  • Submit appeals and reconsiderations for claim rejections, underpayments, and denials.
  • Communicate payer trends related to denials for specific procedures or diagnosis codes.
  • Manage a work queue of accounts receivable and set follow-up activities based on claim status.
• Supervision: Works under the general supervision of the Supervisor of Clinical Denials and Director of Denials Improvement.

Required Qualifications

• License: Active Florida or Compact RN license.
• Certifications:

  • ACLS (AHA or ARC)
  • BLS (AHA or ARC)
  • NIH Stroke Certification (AHA, Apex, Blue Cloud, or equivalent)
• Experience:

  • Minimum 2 years recent experience in a clinical area or case management (LPN/RN preferred).
  • Experience must be consecutive within the past 24 months in a US hospital acute care setting.
• Skills:

  • Clinical Appeal Letter Writing
  • EPIC and EMR expertise within Revenue Cycle
  • Knowledge of CMS guidelines, payer policies, contracts, and administrative bulletins.

Preferred Experience

• Case Management experience is highly preferred.

Additional Requirements

• Degree from an accredited school or institution approved by the Florida Board of Nursing.
• Must have completed all required background checks, education verifications, and health screenings.
• Must complete required facility-specific online orientation modules and training.
• Must have a government-issued photo ID available during hours of service.
• Must comply with all facility-specific document and training requirements (e.g., privacy policy, emergency management, compliance & ethics, infection control, etc.).

Health and Safety Requirements

• Physical exam within 6 months of start, updated annually.
• Negative QuantiFERON TB test within 6 months (no TSPOT or PPD accepted).
• Annual fit mask test with approved masks (3M 1860 Regular or Small).
• Negative 10-panel drug screen within 12 months.
• Required immunizations or proof of immunity:

  • MMR (Rubeola, Mumps, Rubella)
  • Hepatitis B series or declination
  • Varicella vaccination or declination
  • Seasonal flu vaccination or declination (required during flu season)
  • COVID-19 vaccination preferred (tracking purposes).

Prior Travel Experience

• No explicit prior travel experience required.

Notes for Candidates

• Locals within a 60-mile radius are considered.
• Must complete all required online modules and upload certificates of completion as specified.
• Background checks must be current within 6 months and include all required searches.
• Fingerprinting per Florida AHCA Level II requirements is mandatory before start.

This position is ideal for RNs with recent acute care and case management experience who are skilled in clinical denials and appeals, and who meet all licensing, certification, and compliance requirements.