Clinical Appeals Specialist

1 day ago


Atlanta, Georgia, United States Piedmont Full time
Job Summary

Piedmont is seeking a skilled Clinical Appeals Specialist to join our team. As a key member of our appeals process, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.

Key Responsibilities
  • Conduct detailed reviews of patient medical records to extract relevant clinical information
  • Draft compelling narratives for appeals documentation and briefs
  • Stay up-to-date with medical coding, federal and state hospital Utilization Review (UR) regulations, and Medicare guidelines
  • Collaborate with internal and external legal resources to facilitate the best possible outcomes
Requirements
  • Graduate from an accredited School of Nursing
  • Minimum 7 years of clinical experience in a healthcare setting with electronic medical records or acute hospital utilization review
  • Working knowledge of medical coding, case management, government and contracted payers
  • Current Georgia nursing licensure
Preferred Qualifications
  • Experience with clinical software such as SCM / Quest, STAR, EPIC, Client Tracking, and I-Suites
  • IQCI Certification
  • MicroSoft Word and Excel proficiency

Piedmont is an equal opportunity employer and welcomes applications from diverse candidates.



  • Atlanta, Georgia, United States Piedmont Healthcare Corporate Full time

    About the Role:Piedmont Healthcare Corporate is seeking a skilled Clinical Appeals Specialist to join our team. As a Clinical Appeals Specialist, you will be responsible for reviewing and analyzing clinical information from patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key...


  • Atlanta, Georgia, United States Piedmont Full time

    Job Summary:Piedmont is seeking a highly skilled Clinical Appeals Specialist to join our team. As a Clinical Appeals Specialist, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key Responsibilities:Conduct detailed reviews of patient medical...


  • Atlanta, Georgia, United States Piedmont Healthcare Corporate Full time

    About the Role:Piedmont Healthcare Corporate is seeking a highly skilled Clinical Appeals Specialist to join our team. As a Clinical Appeals Specialist, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key Responsibilities:Conduct detailed...


  • Atlanta, Georgia, United States Piedmont Healthcare Corporate Full time

    Job Summary:Piedmont Healthcare Corporate is seeking a highly skilled Clinical Appeals Specialist to join our team. As a Clinical Appeals Specialist, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key Responsibilities:Conduct detailed reviews...


  • Atlanta, Georgia, United States Piedmont Healthcare Corporate Full time

    Job Summary:Piedmont Healthcare Corporate is seeking a highly skilled Clinical Appeals Specialist to join our team. As a Clinical Appeals Specialist, you will be responsible for reviewing and analyzing clinical information from patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key...


  • Atlanta, Georgia, United States Piedmont Healthcare Corporate Full time

    Job Summary:Piedmont Healthcare Corporate is seeking a highly skilled Clinical Appeals Specialist to join our team. As a Clinical Appeals Specialist, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key Responsibilities:Conduct detailed reviews...


  • Atlanta, Georgia, United States Piedmont Full time

    About the Role:Piedmont is seeking a highly skilled Clinical Appeals Specialist to join our team. As a Clinical Appeals Specialist, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key Responsibilities:Conduct detailed reviews of patient...


  • Atlanta, Georgia, United States Piedmont Full time

    About the Role:Piedmont is seeking a highly skilled Clinical Appeals Specialist to join our team. As a Clinical Appeals Specialist, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key Responsibilities:Conduct detailed reviews of patient...


  • Atlanta, Georgia, United States Piedmont Healthcare Corporate Full time

    Job SummaryPiedmont Healthcare Corporate is seeking a skilled Clinical Appeals Specialist to join our team. As a key member of our appeals process, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key ResponsibilitiesConduct detailed reviews of...


  • Atlanta, Georgia, United States Piedmont Full time

    Job SummaryPiedmont is seeking a skilled Clinical Appeals Specialist to join our team. As a key member of our appeals process, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation.Key ResponsibilitiesConduct detailed reviews of patient medical records to...


  • Atlanta, Georgia, United States Piedmont Healthcare Corporate Full time

    Job SummaryPiedmont Healthcare Corporate is seeking a skilled Clinical Appeals Specialist to join our team. As a key member of our appeals process, you will be responsible for reviewing and analyzing patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key ResponsibilitiesConduct detailed reviews of...


  • Atlanta, Georgia, United States Piedmont Healthcare Corporate Full time

    About the Role:Piedmont Healthcare Corporate is seeking a highly skilled Clinical Appeals Specialist to join our team. As a key member of our appeals process, you will be responsible for reviewing and analyzing clinical information from patient medical records to draft effective narratives for Medicare and Medicaid appeals documentation and briefs.Key...


  • Atlanta, Georgia, United States Piedmont Full time

    JOB PURPOSE:The primary responsibility involves a comprehensive evaluation, analysis, and extraction of clinical data from patient medical records. This role focuses on crafting effective narratives for Medicare and Medicaid appeals documentation and briefs in support of cases that have been denied and are currently under appeal at various levels of the...


  • Atlanta, Georgia, United States Piedmont Full time

    JOB PURPOSE:Conduct thorough evaluations, analyses, and extraction of clinical data from patient medical records, while composing effective narratives for Medicare and Medicaid appeals documentation and briefs concerning denied cases at all levels of the governmental appeals process. Maintain an up-to-date knowledge base of medical coding, federal and state...


  • Atlanta, Georgia, United States Piedmont Full time

    JOB PURPOSE:The primary responsibility involves a comprehensive examination, evaluation, and extraction of clinical data from patient medical records. This role focuses on crafting precise narratives for Medicare and Medicaid appeals documentation and briefs concerning denied cases at all levels of the governmental appeals process. It is essential to...


  • Atlanta, Georgia, United States Piedmont HealthCare Full time

    PRIMARY RESPONSIBILITIES:Thorough examination, assessment, and extraction of clinical data from patient medical records, along with the composition ofeffective narratives for Medicare and Medicaid appeals documentation and briefs supporting denied casesunder review at all stages of the governmental appeals process. Keeping up-to-date withmedical coding,...


  • Atlanta, Georgia, United States Piedmont HealthCare Full time

    PRIMARY RESPONSIBILITIES:Thorough examination, assessment, and extraction of clinical data from patient medical records, along with the composition ofpersuasive narratives for Medicare and Medicaid appeals documentation and briefs related to denied casesunder review at all levels of the governmental appeals framework; ensuring up-to-date knowledge ofmedical...


  • Atlanta, Georgia, United States Piedmont Full time

    JOB PURPOSE:The primary responsibility of this role involves a comprehensive examination, analysis, and extraction of clinical data from patient medical records. The aim is to craft compelling narratives for Medicare and Medicaid appeals documentation and briefs to support denied cases throughout all levels of the government appeals process. This position...


  • Atlanta, Georgia, United States Piedmont Full time

    JOB PURPOSE:The primary responsibility involves a comprehensive evaluation, analysis, and extraction of clinical data from patient medical records. This role requires drafting precise narratives for Medicare and Medicaid appeals documentation and briefs, supporting denied cases at all levels of the government appeals process. It is essential to maintain an...


  • Atlanta, Georgia, United States Piedmont Full time

    JOB PURPOSE:The primary responsibility involves a thorough examination, assessment, and extraction of clinical data from patient medical records. This role includes the composition of compelling narratives for Medicare and Medicaid appeals documentation and briefs to support denied cases throughout all stages of the governmental appeals process. The position...