Missouri Licensed Clinical Appeal Writer

Job Summary

Providing expertise in medical necessity justification, the full-time remote Missouri Licensed Clinical Appeal Writer will manage the appeals process for air transport claims, ensuring compliance with clinical standards and maximizing reimbursement for patients and the organization.

Key responsibilities

• Conduct medical necessity appeals for various payor sources, advocating for patients and the organization
• Input appeal requests into the database and ensure timelines are met throughout the appeals process
• Collaborate with the appeal team to develop strategies for addressing clinical denials and optimizing claim reimbursement

Required qualifications

• Current RN licensure is required
• Minimum of five years of experience in Emergency Department, ICU, flight, or ambulance settings
• Some supervisory or leadership experience is preferred
• Bachelor's degree in nursing or equivalent is preferred
• CFRN, CEN, or CCRN certification is preferred