Clinical Appeals Coordinator - Part Time

University of Mississippi Medical Center; Michigan; On-site; USD 30,000 - 47,000; Part time

Job summary

University of Mississippi Medical Center seeks a Clinical Appeals Coordinator to support the billing and denial appeals workflow in Clinton. This part-time role coordinates reviews, researches denials, and collaborates with insurers and clinical teams to minimize financial risk through effective appeals.

Responsibilities include reviewing patient records, submitting timely medical necessity appeals, tracking outcomes, and supporting quality improvement initiatives across the revenue cycle.

Qualifications

• Two (2) years of nursing experience.
• Utilization review and case management experience recommended.
• Knowledge of clinical organization structure, workflow and procedures.
• Ability to analyze and solve problems under time constraints.
• Verbal and written communication skills.
• Interpersonal skills to interact with diverse stakeholders.
• Decision-making skills.

Responsibilities

• Reviews patient medical records and collects data to support billing and appeals management, analysis, and monitoring activities.
• Communicates with insurers to determine the appropriateness of payments or denials.
• Collects, reviews, and submits timely appeals for medical necessity and authorization of denials.
• Conducts clinical research and analysis to identify issues and develop strategies that improve the payment and appeals process.
• Assists with chart audits by reviewing and comparing medical records against itemized patient bills to ensure accuracy and maintain revenue integrity.
• Analyzes denial and payment data to identify trends and patterns, supporting system-wide performance improvement and management education.
• Supports quality improvement initiatives by reviewing clinical practices for consistency, adherence to policy, and appropriate levels of care across settings; prepares reports and communicates findings to clinical and non‑clinical staff.
• Communicates and negotiates with external stakeholders, including insurance payers, regarding appeal outcomes.
• Maintains knowledge of current regulatory and accreditation standards related to denial and appeals management to support organizational compliance.

Skills

Nursing experience

Analytical skills

Communication skills

Time management

Problem solving

Job description

Clinical Appeals Coordinator - Part Time

Location

Central Billing Office, Clinton

Job Details

• Job Requisition ID: R00055029
• Job Category: Nursing
• Organization: Rev Cycle - Patient Access PAU

Job Summary

Coordinates and supports the billing process, including denial and appeal reviews. Evaluates and monitors patient care payment denials and related claims while supporting the development of strategies to minimize financial risk through effective appeals management. Conducts research, collaborates with departments to verify denials, perform clinical reviews, and prepares reports to support quality improvement initiatives and prevent future denials.

Education & Experience

• Two (2) years of nursing experience.

Preferred Qualifications

• Utilization review and case management experience.

Knowledge, Skills & Abilities

• Knowledge and understanding of clinical organization structure, workflow, and operating procedures.
• Skill in the use of personal computers and related software applications.
• Ability to manage multiple priorities under time constraints; ability to analyze and solve problems.
• Understanding cost and quality issues.
• Verbal and written communication skills.
• Interpersonal skills to interact with a wide range of constituencies.
• Decision-making skills.

Responsibilities

• Reviews patient medical records and collects data to support billing and appeals management, analysis, and monitoring activities.
• Communicates with insurers to determine the appropriateness of payments or denials.
• Collects, reviews, and submits timely appeals for medical necessity and authorization of denials.
• Conducts clinical research and analysis to identify issues and develop strategies that improve the payment and appeals process.
• Assists with chart audits by reviewing and comparing medical records against itemized patient bills to ensure accuracy and maintain revenue integrity.
• Analyzes denial and payment data to identify trends and patterns, supporting system-wide performance improvement and management education.
• Supports quality improvement initiatives by reviewing clinical practices for consistency, adherence to policy, and appropriate levels of care across settings; prepares reports and communicates findings to clinical and non‑clinical staff.
• Communicates and negotiates with external stakeholders, including insurance payers, regarding appeal outcomes.
• Maintains knowledge of current regulatory and accreditation standards related to denial and appeals management to support organizational compliance.

Physical and Environmental Demands

Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, occasional exposure to bio‑hazardous conditions such as risk of radiation exposure, blood borne pathogens, fumes or airborne particles, and/or toxic or caustic chemicals which mandate attention to safety considerations, occasional working hours significantly beyond regularly scheduled hours, occasional travelling to offsite locations, occasional work produced subject to precise measures of quantity and quality, occasional bending, occasional lifting and carrying up to 25 pounds, occasional crouching/stooping, occasional kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent standing, occasional twisting, and frequent walking. (occasional‑up to 20%, frequent‑from 21% to 50%, constant‑51% or more)

Employment Details

• Time Type: Part time
• FLSA Designation/Job Exempt: No
• Pay Class: Hourly
• FTE %: 100

Recruitment Dates

• Job Posting Date: 10/23/2026
• Job Closing Date (open until filled if no date specified): 10/27/2026

Company Culture & Inclusion

The University of Mississippi Medical Center is committed to educating the next generation of health professionals, discovering new cures and treatments and providing the highest quality health care. We foster environments that support respect, compassion and belonging for all faculty, staff and students as well as patients and visitors. Our employment, academic, research and clinical care practices reflect these commitments. UMMC is an equal opportunity employer and prohibits discrimination and harassment on the basis of race, color, national origin (including limited English proficiency and primary language), disability, age, sex (as that term is defined in applicable laws such as 45CFR§92.101(a)(2) and binding court decisions), religion, genetic information, veteran’s status and any other status protected by applicable law. UMMC also prohibits retaliation against those who report discrimination or harassment and against those who participate in the Medical Center’s investigation and handling of such reports. Further, UMMC complies with all applicable statutes, regulations and executive orders regarding sex discrimination, sexual harassment, domestic and dating violence, sexual assault and stalking, including but not limited to TitleIX of the Education Amendments of 1972 and its implementing regulations which prohibit discrimination on the basis of sex in any education program or activity UMMC operates including in admission and employment, the JeanneClery Disclosure of Campus Security Policy and Campus Crime Statistic Act (“Clery Act”) and the Campus Sexual Violence Elimination Act (“SaVE Act”). UMMC’s commitment to nondiscrimination applies to all of its programs, services, opportunities and activities, including but not limited to all employment, academic, research and clinical care practices and extends to all students, applicants for admission, employees, applicants for employment, affiliates, subcontractors, on‑site contractual staff, third party or community members, visitors to any of our campuses and others participating in UMMC programs or receiving UMMC services. With respect to employment in particular, this commitment applies to all employment decisions including but not limited to recruitment, employment, training, promotion, compensation, benefits, disciplinary actions and termination. UMMC maintains an affirmative action program in accordance with applicable laws. Consistent with these laws, UMMC takes affirmative action to recruit, employ, advance and prevent discrimination against qualified individuals. For additional information, please check here: KnowYourRights: Workplace discrimination is illegal (eeoc.gov).