Job Summary
A company is looking for a Clinical Appeals Specialist RN.
Key Responsibilities
- Coordinate and manage the Medicaid and Non-Medicaid denial and appeals processes
- Prepare clinical documentation and represent the organization during mediation and appeals hearings
- Maintain accurate records and assist in data collection and reporting related to appeals
Required Qualifications, Training, and Education
- Bachelor's degree in Nursing with active RN licensure in North Carolina
- Two years of post-degree professional experience
- Knowledge of behavioral health and physical health conditions
- Experience in data collection and analysis
- Proficiency in Microsoft Office Suite and relevant reporting systems
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