Registered Nurse Clinical Appeals
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
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
