Registered Nurse Appeal Specialist

Job Summary

Reviewing and resolving insurance denials, the full-time remote Registered Nurse Appeal Specialist will analyze trends, provide feedback to facilities, and collaborate with internal teams to ensure accurate reimbursement and regulatory compliance.

Key responsibilities

• Reviews and resolves pre-payment insurance denials in collaboration with follow-up teams
• Coordinates with Denial Coordinators and Facility Denial Liaisons to ensure payer accountability and identify education opportunities
• Tracks and logs denials and appeal activity according to established documentation and reporting guidelines

Required qualifications

• H.S. Diploma or GED required; Bachelor's Degree in Nursing preferred
• 2-4 years of experience in healthcare revenue cycle or business office required
• 1-3 years of experience in healthcare insurance or medical billing preferred
• RN - Registered Nurse - State Licensure and/or Compact State Licensure required