Oregon Licensed Clinical Appeals Specialist

Job Summary

A company is looking for a Clinical Appeals Specialist (Patient Accounting) - Remote.

Key Responsibilities

• Manage clinical denials by reviewing clinical documentation and formulating written responses
• Communicate denial trends and patterns to relevant management and patient accounting leaders
• Review and improve the clinical denial and appeal process while orchestrating education and performance initiatives

Required Qualifications, Training, and Education

• Minimum 3 years of Clinical RN experience, including 1 year in Denial Management or Case Management
• Active RN license in Oregon or a state approved for remote work
• Bachelor's degree in Nursing or allied health field preferred
• Experience preparing appeals for clinical denials preferred
• Certifications such as CCDS or CCM preferred