RN Appeals Writer Position Available In Fulton, Georgia
Tallo's Job Summary: The RN Appeals Writer at Piedmont Healthcare in Atlanta, Georgia, is responsible for reviewing and analyzing clinical information, drafting narratives for appeals, and staying updated on medical coding and regulations. Qualifications include a nursing degree, 7 years of clinical experience, and Georgia nursing licensure. Knowledge of medical coding and software systems is preferred.
Job Description
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RN Appeals Writer Description:
RESPONSIBLE FOR
Detailed review, analysis and extraction of clinical information from patient medical records and drafting of
effective narratives for Medicare and Medicaid appeals documentation and briefs in support of denied cases
under appeal at all levels of the government appeals process; maintaining current knowledge base of
medical coding, federal and state hospital Utilization Review (UR) regulations and Medicare guidelines
regarding medical necessity, inpatient, outpatient and observation; assisting Senior Director with research
and preparation for beneficiary hearings before the Administrative Law Judge (ALJ); potentially testifying
as expert witness in ALJ hearings; collaborating with internal and external legal resources in an effort to
facilitate the best possible outcomes in response to process or guideline changes that directly impact the
RAC process.
Qualifications:
MINIMUM EDUCATION REQUIRED
Graduate from an accredited School of Nursing
MINIMUM EXPERIENCE REQUIRED
Clinical experience in healthcare setting with a minimum of 7 years using electronic medical records or
acute hospital utilization review using InterQual or Milliman. Working knowledge of medical coding, case
management, government and contracted payers.
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW
Current Georgia nursing licensure.
ADDITIONAL QUALIFICATIONS
Experience in clinical software such as SCM / Quest, STAR, EPIC, Client Tracking, and I-Suites. Previous
experience with medical record auditing with medical necessity claims; IQCI Certification preferred
MicroSoft Word and Excel proficiency preferred. HealthPort systems experience a plus. LI-POST #GD Position Information
LOCATION
Atlanta, Georgia
POSTED 05/16/2025 TYPE
Revenue Cycle
SCHEDULE
Full-time SHIFT Day Job
JOB ID 1894816
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