Appeals Coordinator

Temple-Health; Philadelphia (Philadelphia County); On-site; USD 70,000 - 100,000; Full time

Job summary

Temple Health in Philadelphia is seeking a full-time RN reviewer to assess insurer adverse determinations through all levels of the appeals process. The role focuses on clinical evaluation and evidence-based decision making.

Candidates should have RN training from an accredited school, knowledge of ICD-10 CM coding, and familiarity with InterQual and Milliman criteria; APC coding is a plus. Multistate Compact RN license required.

Qualifications

• 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

Responsibilities

• Responsible for clinically assessing all adverse determinations made by insurers through all levels of the appeals process.

Skills

ICD-10 CM coding

InterQual criteria

Milliman criteria

Education

Graduate of an accredited school of nursing

Tools

InterQual criteria

Milliman criteria

Job description

3401 North Broad Street, Philadelphia, Pennsylvania, United States

Tracking Code

263109

Weekly Hours

40.00

Schedule

Full-Time

Shift

Day Shift

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

• Multi State Compact RN License Required Or