RN- CLINICAL DENIALS & APPEAL

✔️Has at least 1 year of experience writing clinical appeals

✔️Has at least 3 years of hospital acute care experience (Med- Surg or similar) and 2 years of ICU experience

✔️Graduate of Bachelor of Science in Nursing

✔️Active Registered Nurse (RN)/ USRN license 

✔️Experience using InterQual or MCG guidelines

✔️Knowledge of U.S. insurance rules and government healthcare programs

✔️Experience with hospital EMRs (Epic, Cerner, or Meditech

✔️Case management, clinical appeals, or ACMA certification

✔️Experience with denial and appeal tracking systems