Clinical Appeals Liaison

What you will do in this role:

• Review denied insurance claims for medical treatment, thoroughly analyzing patient medical records to determine if the denial was justified
• Prepare comprehensive appeals packages including detailed clinical narratives and necessary supporting medical records, for presentation to insurance companies to substantiate and advocate for patient access to necessary care, utilizing their clinical expertise to support the medical necessity of requested services
• Initiate appeal letters and briefs for denials
• Ensures all appeals are completed within established timelines and in accordance with regulatory and contractual requirements
• Other duties as assigned

• Must be licensed as a RN, LPN/LVN, PT, or OT
• Minimum of 2 years on Inpatient Rehabilitation Hospital experience
• Minimum 3 years of clinical experience
• Excellent oral and written communication and interpersonal skills