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Job details

State Licensed RN Appeal Writer

Job Summary

A company is looking for an Independent Contractor-Hospital RN specializing in Appeal Writing and Denials Management.

Key Responsibilities
  • Perform retrospective medical necessity reviews to determine appeal eligibility of clinical disputes/denials
  • Construct and document clinical cases to support appeals using appropriate medical necessity criteria
  • Demonstrate critical thinking and decision-making skills in the clinical appeal process
Required Qualifications
  • RN or MD degree with an active unrestricted clinical license in at least one U.S. state
  • Minimum of 5 years recent acute-care hospital experience preferred
  • Minimum of 2 years of Utilization Review or Case Management experience within the last 5 years
  • Managed care payor experience in Utilization Review, Case Management, or Appeals is a plus
  • Must be computer proficient

Average salary estimate

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EMPLOYMENT TYPE
Contract, remote
DATE POSTED
May 28, 2025

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