Job Opportunity - Appeals CHC Nurse

Eden Brown Synergy; Welwyn; On-site; GBP 31,000 - 39,000; Full time

Job summary

A healthcare recruitment firm is seeking an experienced Band 6 Appeals Nurse in Welwyn. The role focuses on managing and supporting the clinical review process for Continuing Healthcare appeals. Responsibilities include conducting clinical reviews, preparing case summaries, and liaising with appellants. The ideal candidate will contribute to reducing the backlog of appeals while ensuring compliance with national timelines. This is an excellent opportunity to make a significant impact within the healthcare sector.

Responsibilities

• Conduct thorough clinical and documentary reviews of appeal cases.
• Prepare detailed case summaries and recommendations for resolution panels.
• Communicate with appellants and representatives to explain the appeal process.
• Maintain accurate documentation to minimize risks regarding unresolved appeals.

Job description

Overview

We are seeking an experienced Band 6 Appeals Nurse to join our team. The primary focus of this role will be to manage and support the clinical review, case management, and decision‑making process for both retrospective and current Continuing Healthcare (CHC) appeals. The successful candidate will help reduce an identified backlog, working towards meeting the national six‑month appeal response target.

Key Responsibilities

• Conduct thorough clinical and documentary reviews of appeal cases, assessing CHC eligibility and needs in line with the National Framework.
• Prepare detailed case summaries and recommendations, presenting cases at local resolution and appeal panels as required.
• Communicate directly with appellants, families, attorneys, and representatives to explain the appeal process, outcomes, and next steps, ensuring local resolution when possible.
• Contribute to maintaining accurate documentation, minimising risks, and ensuring compliance with national timelines to reduce financial, legal, and reputational risks linked to unresolved appeals.

Equal Opportunities

Eden Brown Synergy is an equal opportunities employer.