RN Appeal Specialist

Job Summary

Reviewing and resolving insurance denials, the full-time remote RN Appeal Specialist will analyze reimbursement issues, collaborate with internal teams, and provide feedback to facilities while ensuring compliance with regulatory standards.

Key responsibilities

• Reviews and resolves pre-payment insurance denials in collaboration with follow-up teams
• Tracks and logs denials and appeal activity according to established documentation and reporting guidelines
• Monitors payer billing and coding updates and communicates changes to relevant departments

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