Appeals Coordinator

Our take on this role

About this role

Assess adverse determinations made by insurers through all levels of the appeals process using clinical knowledge.

What could you bring from clinical work?

• Nurses: Your experience assessing patients and documenting clinical findings could help when clinically assessing insurer adverse determinations throughout the appeals process.

Full job description from Temple Health

Responsible for clinically assessing all adverse determinations made by insurers through all levels of the appeals process.
Education
Other Graduate of an accredited school of nursing Required
Experience
General Experience and knowledge of InterQual and Milliman criteria. Required
General Experience and working knowledge of ICD-10 CM coding Required
General Experience and Knowledge of APC coding Preferred
Licenses
PA Registered Nurse License Required
Multi State Compact RN License Required Or