Clinical Appeals Supervisor — Denials & Compliance Lead

Community Health Systems; Franklin (TN); Remote; USD 70,000 - 95,000; Full time

Benefits offered by this job

Health coverage

401(k) matching

Student loan repayment

Tuition assistance

Competitive pay

Job summary

Community Health Systems is seeking a Supervisor, Clinical Appeals to oversee the coordination of audit and medical necessity denial appeals for their assigned team. This role ensures timely and accurate appeal submissions, compliance with regulatory standards, and the achievement of service and production goals.

The Supervisor provides day-to-day leadership, supports standardized appeal processes, and works to identify trends and mitigate denial risks in collaboration with the Senior Director.

Qualifications

• H.S. Diploma or GED required.
• Associate Degree in Nursing, Healthcare Administration, or related field preferred.
• 3–5 years of experience in healthcare appeals/denials management.
• 1–2 years of leadership or supervisory experience preferred.

Responsibilities

• Supervises team reviewing and submitting medical necessity denial appeals.
• Maintains communication with RACs and other auditors.
• Monitors team performance to ensure regulatory compliance and deadlines.
• Conducts research to support appeals and guides documentation quality.
• Identifies denial trends and opportunities for process improvements.
• Collaborates with physician advisors and senior leadership on policy updates.
• Ensures data collection and reporting accuracy using Compliance 360 or similar tools.
• Delivers training on appeals processes and documentation requirements.

Skills

Healthcare appeals

Regulatory compliance

Leadership

Data management

Communication

Analytics

Office suites

Education

H.S. Diploma or GED

Associate degree in Nursing or Healthcare Administration

Tools

Compliance 360

Google Suite

Microsoft Office

Job description

Community Health Systems is seeking a Supervisor, Clinical Appeals to oversee the coordination of audit and medical necessity denial appeals for their assigned team. This role ensures timely and accurate appeal submissions, compliance with regulatory standards, and the achievement of service and production goals.

The Supervisor provides day-to-day leadership, supports standardized appeal processes, and works to identify trends and mitigate denial risks in collaboration with the Senior Director.