RN Appeals Writer

3 weeks ago


Atlanta, United States Piedmont Healthcare Corporate Full time
Description:
**Appeal Experience REQUIRED**

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.

#GD #LI-POST
  • RN Appeals Writer

    1 month ago


    Atlanta, United States Piedmont Healthcare Corporate Full time

    Description:**Appeal Experience REQUIRED**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...

  • RN Appeals Writer

    1 month ago


    Atlanta, United States Piedmont Healthcare Corporate Full time

    Description:**Appeal Experience REQUIRED**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...

  • RN Appeals Writer

    1 month ago


    Atlanta, United States Piedmont Healthcare Full time

    Description: **Appeal Experience REQUIRED** 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...

  • RN Appeals Writer

    4 weeks ago


    Atlanta, Georgia, United States Piedmont Healthcare Corporate Full time

    :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...

  • RN Appeals Writer

    4 weeks ago


    Atlanta, GA, United States Piedmont Full time

    Description Appeal Experience REQUIRED** 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...

  • RN Appeals Writer

    3 weeks ago


    Atlanta, United States Piedmont Healthcare Corporate Full time

    Description:**Appeal ExperienceREQUIRED**RESPONSIBLE FOR:Detailed review, analysis and extraction ofclinical information from patient medical records and drafting ofeffective narratives for Medicare and Medicaid appealsdocumentation and briefs in support of denied cases underappeal at all levels of the government appeals process; maintainingcurrent knowledge...

  • DRG Appeals Writer

    1 month ago


    Atlanta, United States Piedmont Healthcare Corporate Full time

    Description: JOB PURPOSE: The individual in this position on behalf of the entire Piedmont System will be responsible for managing the administrative appeal of reimbursement claims denied by Medicare or Medicaid on the grounds that the medical coding was incorrect. These duties involve coordination of activities with the managers of coding at each of the...

  • DRG Appeals Writer

    4 weeks ago


    Atlanta, Georgia, United States Piedmont Healthcare Full time

    JOB PURPOSE:The individual in this position on behalf of the entire Piedmont System will be responsible for managing the administrative appeal of reimbursement claims denied by Medicare or Medicaid on the grounds that the medical coding was incorrect. These duties involve coordination of activities with the managers of coding at each of the Piedmont...

  • RN Appeals Writer

    1 day ago


    Atlanta, United States Piedmont Healthcare Corporate Full time

    Description:JOB PURPOSE:Detailed review,analysis and extraction of clinical information from patientmedical records and drafting of effective narratives for Medicareand Medicaid appeals documentation and briefs in support of deniedcases under appeal at all levels of the government appeals process;maintaining current knowledge base of medical coding, federal...

  • RN Appeals Writer

    2 weeks ago


    Atlanta, United States Piedmont Healthcare Corporate Full time

    Description:JOB PURPOSE: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,...

  • RN Appeals Writer

    2 weeks ago


    Atlanta, United States Piedmont Healthcare Corporate Full time

    Description:JOB PURPOSE: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,...

  • RN Appeals Writer

    4 weeks ago


    Atlanta, Georgia, United States Piedmont Healthcare Corporate Full time

    :RESPONSIBLE FOR:Detailed review, analysis and extraction ofclinical information from patient medical records and drafting ofeffective narratives for Medicare and Medicaid appealsdocumentation and briefs in support of denied cases underappeal at all levels of the government appeals process; maintainingcurrent knowledge base of medical coding, federal...

  • RN Appeals Writer

    1 month ago


    Atlanta, United States Piedmont Healthcare Corporate Full time

    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...

  • RN Appeals Writer

    3 weeks ago


    Atlanta, United States Piedmont Healthcare Corporate Full time

    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...

  • RN Appeals Writer

    3 weeks ago


    Atlanta, United States Piedmont Healthcare Full time

    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...

  • Nurse Appeals

    2 weeks ago


    Atlanta, United States Elevance Health Full time

    Nurse Appeals – Licensed RN Nurse Location: This position will work in a hybrid model (remote and office). Ideal candidates will live in Virginia, Georgia, Florida, Indiana, or Ohio within 50 miles of one of our PulsePoint locations. Shift: Monday to Friday from 8:00 am - 5:00 pm ET or Tuesday to Saturday from 8:00 am – 5:00 pm ET (will work weekends and...

  • RN Appeals Writer

    4 weeks ago


    Atlanta, United States Piedmont Healthcare Corporate Full time

    Description:RESPONSIBLE FOR:Detailed review, analysis and extraction ofclinical information from patient medical records and drafting ofeffective narratives for Medicare and Medicaid appealsdocumentation and briefs in support of denied cases underappeal at all levels of the government appeals process; maintainingcurrent knowledge base of medical coding,...

  • UX Designer

    4 weeks ago


    Atlanta, Georgia, United States Brooksource Full time

    UX Designer (Newsletter & Email Marketing Specialist) Atlanta, GA (Hybrid) Contract-to-Hire We are seeking a Tactical UI/UX Designer with expertise in newsletter and email marketing design to join our Media & Journalism on a Contract-to-Hire basis. This individual will play a pivotal role in the day-to-day design operations, focusing on the tactical...

  • RN, Targeted Review,

    17 hours ago


    Atlanta, United States Kaiser Permanente Full time

    Job Summary: Responsible for carrying out precertification and medical necessity reviews on all designated referrals as well as targeted outpatient procedures, services and inpatient admissions. The activities will include telephonic review for medical necessity of the RN designated targeted outpatient procedures, services and inpatient admissions, as well...

  • Travel Nurse RN

    19 hours ago


    Atlanta, United States RNnetwork Full time

    RNnetwork is seeking a travel nurse RN Float Med Surg / Telemetry for a travel nursing job in Atlanta, Georgia.Job Description & RequirementsSpecialty: Med Surg / TelemetryDiscipline: RNStart Date: 07/29/2024Duration: 8 weeks36 hours per weekShift: 12 hours, nightsEmployment Type: TravelAs a medical/surgical/telemetry nurse in the vibrant city of Atlanta,...