Location

New York, New York

Shift:

Day (United States of America)

Description:

Feel the Pride of Revenue Management at Its Best

Behind every patient success story—and before every clinical breakthrough—stands the exceptional team at NewYork-Presbyterian Hospital (NYP). With leading specialists across every field of medicine, NYP’s innovations continue to transform lives around the world. By uniting the strength of two renowned academic medical centers—NYP/Columbia University Irving Medical Center and NYP/Weill Cornell Medical Center—we deliver the highest standard of inpatient, ambulatory, and preventive care.

Revenue Management Specialist – RN (Days)

Under the guidance of a highly supportive and collaborative Manager, the Revenue Management Specialist utilizes strong clinical expertise to ensure accurate reimbursement and compliance with payer requirements. This role plays a critical part in the hospital’s revenue cycle by providing concurrent and retrospective clinical reviews, managing payer denials, and supporting regulatory initiatives.

Key Responsibilities

• Provide concurrent and retrospective clinical documentation to support reimbursement and meet third-party payer requirements.

• Review medical necessity based on authorization outcomes from precertification processes.

• Manage and respond to denials from third-party payers within required timeframes, ensuring timely resolution.

• Monitor all incoming payer correspondence and end-of-day reports to ensure accuracy, authorization status, and compliance.

• Actively support hospital-wide initiatives, including the 2-Midnight Stay Rule, by reviewing all one- and two-day stays for appropriate patient status and facilitating conversions when indicated.

• Collaborate with interdisciplinary teams to promote best practices in utilization management and revenue integrity.

This role is ideal for a clinically experienced RN who thrives in a fast-paced environment, values analytical thinking, and wants to make a measurable impact on both patient care and organizational performance.

Preferred Criteria

• Bachelor’s Degree in Nursing (BSN) 

• Experience with Microsoft Excel

Required Criteria 

• New York State License as a Registered Nurse

• Minimum of 3 years of clinical experience or denial management experience 

• Ability to work independently with minimal supervision 

• Self-motivated individual who possesses critical thinking skills with strong ability to review and interpret clinical information. 

• Proficient computer skills – Microsoft Word  

Join a healthcare system where employee engagement is at an all-time high. Here we foster a culture of respect, belonging, and inclusion. Enjoy comprehensive and competitive benefits that support you and your family in every aspect of life. Start your life-changing journey today.

Please note that all roles require on-site presence (variable by role). Therefore, all employees should live within a commutable distance to NYP.

NYP will not reimburse for travel expenses.

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• 2025 Best Employers for Women – Forbes

• 2025 Companies that Care – People

• 2025 America’s Greatest Workplaces for Mental Well-Being - Newsweek

NewYork-Presbyterian Hospital is an equal opportunity employer.

Salary Range:

$126,000-$167,500/Annual

It all begins with you. Our amazing compensation packages start with competitive base pay and include recognition for your experience, education, and licensure. Then we add our amazing benefits, countless opportunities for personal and professional growth and a dynamic environment that embraces every person. Join our team and discover where amazing works.