Appeals Nurse Coordinator II - Clinical Denials & AI Tools

Xsolis; Franklin (TN); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

401K company match

Flexible Paid Time Off

Paid parental leave

HSA/FSA options

Educational reimbursement program

Employer-paid EAP & Mental Health

Job summary

Xsolis, an AI-driven healthcare technology company headquartered in Franklin, TN, seeks an Appeals Nurse Coordinator II to support concurrent reviews, denials, and appeals for our clients. You will review documentation for medical necessity, level of care, and ICD-10 coding, collaborating with payers and providers using AI-enabled tools to improve accuracy and efficiency of clinical review workflows.

This role requires active RN or LPN license, strong communication, and the ability to manage

Qualifications

• Active RN or LPN license.
• Experience reviewing medical records.
• Strong written and verbal communication.
• Ability to organize and manage multiple cases.
• Familiarity with ICD-10, DRG concepts, and EMR systems.
• Experience with AI-enabled tools in clinical review.
• Proficiency with MS Word and Excel.

Responsibilities

• Perform clinical reviews per payer and CMS requirements.
• Determine appropriate level of care and medical necessity.
• Review ICD-10 coding and DRG assignment documentation.
• Support denial management and appeal preparation.
• Provide feedback on care level, LOS, and documentation trends.
• Identify requests for additional medical-record information.
• Use AI-enabled tools to improve research and workflow efficiency.
• Stay current with regulatory changes affecting reviews.

Skills

RN license

Clinical documentation

Utilization management

ICD-10/DRG knowledge

AI-enabled tools

MS Word & Excel

Communication skills

Case management

Tools

Epic

Cerner

Meditech

MS Word

MS Excel

Job description

Xsolis, an AI-driven healthcare technology company headquartered in Franklin, TN, seeks an Appeals Nurse Coordinator II to support concurrent reviews, denials, and appeals for our clients. You will review documentation for medical necessity, level of care, and ICD-10 coding, collaborating with payers and providers using AI-enabled tools to improve accuracy and efficiency of clinical review workflows.

This role requires active RN or LPN license, strong communication, and the ability to manage