Clinical Appeals Nurse Coordinator (RN)

Temple University Health System, Inc.; Philadelphia (Philadelphia County); On-site; USD 65,000 - 90,000; Full time

Job summary

Temple University Health System, Inc. seeks an Appeals Coordinator to clinically assess all insurer adverse determinations through the full appeals process. The role supports reimbursement workflows and patient access, reporting to nursing leadership.

Required RN license (PA) and multi-state compact; experience with InterQual and Milliman criteria and ICD-10 CM coding is expected, APC coding knowledge preferred.

Qualifications

• Graduate of an accredited school of nursing.
• Experience with InterQual and Milliman criteria.
• Knowledge of ICD-10 CM coding; APC coding preferred.

Responsibilities

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

Skills

InterQual & Milliman criteria

ICD-10 CM coding knowledge

APC coding knowledge

Education

RN license (PA)

Multi State Compact RN License

Job description

Temple University Health System, Inc. seeks an Appeals Coordinator to clinically assess all insurer adverse determinations through the full appeals process. The role supports reimbursement workflows and patient access, reporting to nursing leadership.

Required RN license (PA) and multi-state compact; experience with InterQual and Milliman criteria and ICD-10 CM coding is expected, APC coding knowledge preferred.