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Requirement: Must be a LVN or RN with prior MDS experience.Prior experience with appeals, denials, and audits preferred.Must be located in the Dallas/Ft.Worth area as this is a Hybrid positio... Show more
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The average salary range is between $ 40,950 and $ 90,663 year , with the average salary hovering around $ 55,745 year .
Requirement: Must be a LVN or RN with prior MDS experience. Prior experience with appeals, denials, and audits preferred.
This is NOT a Remote position. Must be located in the Dallas/Ft. Worth area as this is a Hybrid position based out of our Carrollton office.
Job Summary
Clinical Appeals & Revenue Specialist
Responsible for managing denied claims and payer audits, preparing and submitting appeal letters and medical records, reviewing clinical documentation for medical necessity, validating coding accuracy, identifying trends in denials, collaborating with MDS team and facility teams to improve outcomes, and ensuring compliance with Medicare, Medicaid, and commercial payer requirements. This position serves as the primary resource for revenue recovery through effective denial prevention, appeal management, and documentation integrity initiatives.
Key duties:
Review and analyze denied claims
Draft and submit appeal and reconsideration letters
Validate ICD-10, CPT, HCPCS, and coding as applicable
Support ADRs, UPICs, TPE, RAC, and payer audits
Track appeal outcomes and denial trends
Educate clinical staff on documentation deficiencies
Recover lost revenue through successful overturn of denials
Maintain compliance with payer and regulatory requirements
To submit your application for this role, please apply here or email your resume to melissa.collier@crgrehab.com
Continuum Rehab Group provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
