Independent Contractor-Hospital RN (Appeal Writing/Denials Mgmt) (Remote)

CorroHealth; United States; Remote; USD 60,000 - 80,000; Part time

Job summary

CorroHealth is seeking an Independent Contractor-Hospital RN for a remote role focused on appeals and denials management. This position demands expertise in retrospective clinical case reviews and medical necessity evaluations. Ideal candidates will hold an active RN or MD license, with significant experience in acute-care settings and utilization review.

Qualifications

• At least 5 years recent acute-care hospital experience (preferred).
• At least 2 years in Utilization Review or Case Management within the last 5 years.
• Managed care payor experience is a plus.

Responsibilities

• Performing medical necessity reviews to determine appeal eligibility.
• Constructing fact-based clinical cases supporting appeals using appropriate criteria.

Skills

Critical thinking

Attention to detail

Strong communication skills

Computer proficiency

Education

Active unrestricted RN or MD license in the U.S.

Job description

Independent Contractor-Hospital RN (Appeal Writing/Denials Mgmt) (Remote)

Join to apply for the Independent Contractor-Hospital RN (Appeal Writing/Denials Mgmt) (Remote) role at CorroHealth.

This position involves evaluating hospitalizations nationwide, performing retrospective clinical case reviews, and drafting appeals focused on establishing the Medical Necessity of services, both Inpatient and Outpatient.

Responsibilities include:

• Performing medical necessity reviews to determine appeal eligibility.
• Constructing fact-based clinical cases supporting appeals using appropriate criteria.
• Demonstrating critical thinking and decision-making skills to support the appeal process.

Qualifications:

• RN or MD with active unrestricted license in the U.S.
• At least 5 years recent acute-care hospital experience (preferred).
• At least 2 years in Utilization Review or Case Management within the last 5 years.
• Managed care payor experience is a plus.
• Attention to detail, strong communication skills, and computer proficiency.

This is a part-time, flexible independent contractor role, requiring a minimum of 20 hours weekly, with compensation as specified for training, meetings, and appeals.

Physical Demands:

Work involves computer use, sitting for prolonged periods, and occasional lifting up to 20 lbs. Reasonable accommodations will be provided as needed.

Additional Information:

This job posting is active and accepting applications.