RN Clinical Appeals Reviewer

Job Summary

A company is looking for an IBR Clinical Appeals Reviewer.

Key Responsibilities:

• Analyze and respond to IBR Appeals and medical record reviews
• Collaborate with auditors and leadership to review medical records and claims
• Research and prepare written appeals based on regulatory and payer protocols

Required Qualifications:

• Associates degree or higher
• Unrestricted RN (registered nurse) license
• 2+ years of appeals experience, including CPT-4 coding and auditing
• Advanced proficiency in ICD10 CM and ICD 10 PCS coding
• Ability to work during normal business hours of 8:00am - 5:00pm