RN Medical Appeals Analyst

A company is looking for an AR Medical Appeals Analyst to review and generate medical appeals to carriers. Key Responsibilities Review medical claim denials and determine appropriate appeals to submit Generate medical appeals related to medical necessity and other categories Ensure timely filing of appeals and maintain confidentiality of patient information Required Qualifications, Training, and Education Certified Registered Nurse (RN) or Licensed Practical Nurse (LPN) preferred Minimum two years of relevant experience in claim processing or clinical denials required Proficiency in MS Office applications (Word & Outlook) required Strong analytical skills and ability to interpret insurance contracts and medical records required Familiarity with regulatory requirements and MCG Guidelines for medical necessity required

Feb 13, 2025 - 17:32

A company is looking for an AR Medical Appeals Analyst to review and generate medical appeals to carriers. Key Responsibilities Review medical claim denials and determine appropriate appeals to submit Generate medical appeals related to medical necessity and other categories Ensure timely filing of appeals and maintain confidentiality of patient information Required Qualifications, Training, and Education Certified Registered Nurse (RN) or Licensed Practical Nurse (LPN) preferred Minimum two years of relevant experience in claim processing or clinical denials required Proficiency in MS Office applications (Word & Outlook) required Strong analytical skills and ability to interpret insurance contracts and medical records required Familiarity with regulatory requirements and MCG Guidelines for medical necessity required