Appeals Specialist II - RN

Job description

Benefits: - Comprehensive Health Coverage – Medical, dental, and vision plans to keep you and your family healthy. - Future Security: 401(k) with matching - Student Loan Support – Up to $10,000 repayment assistance, because we invest in your future. - Educational Tuition Assistance - Competitive Pay & Full Benefits – A salary and package designed to reward your expertise and dedication. Job Summary: The Appeal Specialist II reviews, analyzes, and resolves insurance denials to ensure accurate reimbursement and regulatory compliance. This role logs and reviews denials for trend reporting, provides feedback to facilities, and communicates payer updates to relevant stakeholders. The Appeal Specialist II collaborates with internal teams to ensure timely and thorough appeal resolution and supports initiatives that improve denial prevention and recovery processes. Essential Functions: - Reviews and resolves pre-payment insurance denials in collaboration with follow-up teams. - Coordinates with Denial Coordinators, Facility Denial Liaisons, and Managed Care Coordinators to ensure payer accountability and identify education opportunities. - Provides feedback to facilities regarding denials...