Appeals Nurse

Join Our Team as an Appeal RN - Make a Difference in Patient Advocacy!

Are you a detail-oriented Registered Nurse (RN) with a passion for patient advocacy and healthcare compliance? Do you thrive in a fast-paced environment where your expertise in medical necessity and insurance appeals can directly impact patient care? If so, we want YOU to join our team as an Appeal RN!

Why You'll Love This Role:

Impactful Work - Help ensure patients receive the care they need by crafting compelling appeals and navigating complex payer regulations.
Competitive Compensation - We recognize your expertise with a strong salary and benefits package.
Growth & Development - Access ongoing career advancement opportunities in a dynamic healthcare environment.

What You'll Do:

Appeals work under the IDR team handling on average 10 cases a day. These will be a mix between simple and complex cases. Will be reviewing documentation, codes, and more for out of Network bills and cost and making determinations on how to move forward based on the evidence.

What You Bring to the Table:

✔ Active NY RN License
✔ Experience in Utilization Review, Case Management, or Appeals & Denials preferred.
✔ Excellent critical thinking and writing skills to craft persuasive appeals.
✔ Ability to navigate EMRs and insurance portals with ease.

Education: BSN required

Experience: Appeals experience not required. Open to various clinical backgrounds/experience

Location: 100% in offce required; New Hyde Park, NY

Hours: M-F 7a-5:30p *flexible schedule

Start date: April 14th

Pay: $50-54/hr *DOE

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.