Discharge Planning & Appeals Specialist (RN/LPN or SW)

Springhillmedicalcenter; Mobile (AL); On-site; USD 52,000 - 76,000; Full time

Job summary

Springhill Medical Center is seeking a qualified RN/LPN or Social Worker to influence outcomes for a designated caseload and to manage appeals per payer rules. The role requires timely entry and follow-up on discharge planning and appeals, with letters addressing denial reasons supported by clinical data.

Applicants must be licensed in Alabama (RN or LPN) or as a Social Worker; BSN preferred for nurses. At least one year of case management or discharge planning experience and proficient MS

Qualifications

• Must be an LPN/RN or Social Worker.
• Nurse requirements: nursing degree, LPN/RN license, Alabama licensure, BSN preferred.
• Social Worker: SW degree and Alabama licensure.

Responsibilities

• Influence clinical and financial outcomes for a caseload.
• Manage entry, follow-up and appeals per payer rules.
• Write appeal letters with clinical data to support denial.
• Communicate with BO, Case Management, Payers, HIM about denials.

Skills

Case Management

Discharge Planning

Critical Thinking

Microsoft Office

Decision Making

Education

LPN/RN

Social Worker Degree

Job description

Springhill Medical Center is seeking a qualified RN/LPN or Social Worker to influence outcomes for a designated caseload and to manage appeals per payer rules. The role requires timely entry and follow-up on discharge planning and appeals, with letters addressing denial reasons supported by clinical data.

Applicants must be licensed in Alabama (RN or LPN) or as a Social Worker; BSN preferred for nurses. At least one year of case management or discharge planning experience and proficient MS