Registered Nurse Clinical Appeals

Job is Expired

Location: Remote

Compensation: Salary

Reviewed: Tue, May 06, 2025

Job Category: Healthcare

Weekly Hours: Full Time

Employment Status: Permanent

Employer Type: Employer

Career Level: Experienced

Education Level: Bachelors, Masters

Job Summary

A company is looking for a Clinical Denials and Appeals RN.

Key Responsibilities

Conduct medical necessity reviews and secure pre-service approvals
Perform comprehensive denial root-cause analysis and retrospective medical record reviews
Coordinate peer-to-peer reviews and construct warranted appeals

Required Qualifications

Bachelor's Degree (relevant experience may substitute for formal education)
Current Registered Nursing License
Minimum 4-6 years of prior clinical experience
Familiarity with medical records assembly and clinical terminology
Basic knowledge of coding guidelines is beneficial

COMPLETE JOB DESCRIPTION

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Job is Expired

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