Appeals Specialist

Pre-Employment Requirements:

We are a drug free facility. Passing a pre-employment drug screening is required .

Education/Experience Requirements:

Current RN License, BSN preferred. Minimum of 2 years of experience with clinical validation denials, DRG downgrade denials, and appeal writing. Strong understanding of ICD-10 coding guidelines and clinical documentation standards. Knowledge of payer audit processes, RACs, commercial payer reviews, and denial rationale interpretation. Excellent written communication and clinical documentation analysis skills. Strong critical thinking and attention to detail. Proficiency with electronic medical records and Microsoft Office applications.