Clinical Appeals Registered Nurse

A company is looking for a Clinical Denial / Appeals RN.

Key Responsibilities

Review, analyze, and appeal clinical denials from insurance companies and third-party payers

Conduct comprehensive denial root-cause analysis and ensure documentation integrity

Coordinate pre-service authorization approvals and construct warranted appeals

Required Qualifications

Bachelor's Degree (relevant experience may substitute for formal education)

Current Registered Nursing License

4+ years of prior clinical experience

1+ years of experience in post-claim clinical appeals