RN Clinical Appeals Reviewer

A company is looking for an IBR Clinical Appeals Reviewer - Remote.

Key Responsibilities

Analyze and respond to IBR Appeals inquiries

Perform medical record reviews and prepare written appeals

Collaborate with auditors and leadership to review impacted claims

Required Qualifications

Undergraduate nursing degree

Unrestricted RN (registered nurse) license

2+ years of appeals experience (coding or auditing)

Experience with CPT-4 and ICD10 CM / PCS coding

Advanced knowledge of regulations and compliance in appeals