Part-Time Clinical Appeals Strategist

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

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.