North Carolina Licensed Clinical Appeals Specialist RN

Job Summary

A company is looking for a Clinical Appeals Specialist RN.

Key Responsibilities

• Coordinate and manage the Medicaid and Non-Medicaid denial and appeals processes
• Prepare clinical documentation and represent the organization during mediation and appeals hearings
• Maintain accurate records and assist in data collection and reporting related to appeals

Required Qualifications, Training, and Education

• Bachelor's degree in Nursing with active RN licensure in North Carolina
• Two years of post-degree professional experience
• Knowledge of behavioral health and physical health conditions
• Experience in data collection and analysis
• Proficiency in Microsoft Office Suite and relevant reporting systems