Appeal Nurse

Woodham is searching for a clinical revenue Appeal Nurse!

The selected candidate will be responsible for identifying, analyzing, and resolving insurance company denials specifically related to medical necessity.

Qualifications:

BSN, RN, or comparable degree required

Experience with denials and appeals process a must

2 plus years of nursing experience in an acute care setting

CCDS/CCS a plus

1 plus years of CDI experience a plus

Essential Responsibilities:

Perform retrospective medical necessity audits to identify reason/cause for denials, and identify any potential gaps in documentation or lost charges

Initiates appeals process by researching medical necessity and writing appeal letters intended to effectively obtain reimbursement where applicable for charges billed

Contact HR Manager, Paola Ospina, to be considered for this position.

Job Type: Full-time

Required education:

• Bachelor’s

Required experience:

• nursing in an acute care setting: 2 years
• CDI: 1 year
• denials and reimbursement: 1 year