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CategoryHealthcare
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No of Jobs1
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Apply Before12/08/2025
Description
RN Appeals Writer
Piedmont - Atlanta, GA
Job Title: RN Appeals Writer
Position: Clinical Review Specialist
Job Type:
Pay:
Shift:
Work Type:
Location
Address:
City: Atlanta
State: GA
ZIP Code:
Job Responsibilities
- Conduct detailed review, analysis, and extraction of clinical information from patient medical records.
- Draft effective narratives for Medicare and Medicaid appeals documentation and briefs in support of denied cases.
- Maintain current knowledge base of medical coding, federal and state hospital Utilization Review (UR) regulations, and Medicare guidelines regarding medical necessity.
- Assist Senior Director with research and preparation for beneficiary hearings before the Administrative Law Judge (ALJ).
- Potentially testify as an expert witness in ALJ hearings.
- Collaborate with internal and external legal resources to achieve optimal outcomes related to process or guideline changes impacting the RAC process.
Required Skills
Core Skills
- Experience using electronic medical records
- Clinical experience in healthcare setting
- Knowledge of medical coding
- Utilization Review (UR) expertise
- Familiarity with InterQual or Milliman
Preferred Skills
- Experience with clinical software such as SCM / Quest, STAR, EPIC, Client Tracking, and I-Suites
- Experience with medical record auditing for medical necessity claims
- IQCI Certification
- MicroSoft Word and Excel proficiency
- HealthPort systems experience
Requirements
Experience: Minimum of 7 years in a healthcare setting.
Education: Graduate from an accredited School of Nursing
License & Certification:
- Current Georgia nursing licensure
Schedule:
COVID-19 Requirements: Not Specified
Benefits
- Not specified
Supplemental Pay
- Not specified
Special Notes
- Not specified
Facility Details
Name: Piedmont
Description: Not Specified
Specialties:
- Not specified
Mission: Not Specified
Job Info
Discipline:
Department:
Status:
Sourcing
Duration:
Experience:
Career Level:
No of Jobs:
1
Apply Before:
12/08/2025
Posted:
09/08/2025
