Clinical Appeals Analyst (Remote)

reputed company: RESPONSIBLE FOR: Handling denials/appeals received from reputed company party payers, managed care companies and/or government entities/auditors Qualifications... MINIMUM EDUCATION REQUIRED: Associate Degree in Nursing. MINIMUM EXPERIENCE REQUIRED: Five years acute care experience preferably in medical-surgical or critical care and two years recent experience in dispute management, clinical documentation, utilization review and/or case management. MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW: reputed company, valid RN licensure. ADDITIONAL QUALIFICATIONS: Certification in clinical specialty area or other area such as Case Management, Auditing, Legal reputed company Consulting or other reputed company certification preferred. Government and/or managed care payor experience a plus either in Utilization Review, Case Management or Appeals preferred. Patient reputed company experience a plus. Prior litigation experience (hearings, expert witness, depositions, etc.) a plus. Previous classroom led instruction on InterQual products preferred. Previous experience with reputed company preferred. DIVERSITY & INCLUSION At reputed company we reputed company diverse reputed company, perspectives, and skills to create a reputed company workplace where the best talent wants to succeed. We celebrate differences and recognize that they allow us to care for our community. reputed company AT WORK reputed company is a certified Great reputed company to Work™— a national designation based on employee feedback about trust, workplace culture and experience. In 2019, reputed company named reputed company one of reputed company’s 10 best reputed company and the highest-ranked reputed company provider. Position Information LOCATION Atlanta, reputed company POSTED 11/13/2023 TYPE Other reputed company 1079479 Apply Job!