Remote Clinical Appeals Advocate — Elevate Patient Access

Baxter; Deerfield (IL); Remote; USD 60,000 - 83,000; Full time

Benefits offered by this job

Health insurance

Dental coverage

401(k) with match

ESPP

Paid time off 20-35 days

Parental leave

Commuting benefits

Job summary

Baxter is seeking a Clinical Appeals Advocate to support patients denied insurance coverage for Respiratory Health products. You will work with patients, healthcare teams, and payers to overturn denials and secure access to medically necessary therapies, advancing our mission to Save and Sustain Lives.

This role requires clinical understanding, excellent communication, and the ability to navigate complex payer policies.

Qualifications

• RN/RT/LPN with active state licensure or certification.
• Associate degree or higher, or equivalent work experience in a clinical/reimbursement field.
• Minimum of 3 years reviewing medical records and securing third-party reimbursement.
• Knowledge of federal, state, and local regulations including HIPAA and payer guidelines.
• Exceptional written and verbal communication with strong attention to detail.
• Ability to multitask, prioritize, and work independently or in a team.
• Strong critical-thinking and problem-solving abilities; proficient with Microsoft Office.

Responsibilities

• Assess cases, develop appeal strategies, gather clinical documentation, and prepare submissions for payers.
• Communicate with patients to explain appeal strategies and support hearings when applicable.
• Create clinical case summaries and strengthen documentation for challenging payers.
• Process favorable decisions promptly and negotiate payments when denials are upheld.
• Build relationships with case managers and medical directors to promote positive outcomes.
• Discuss payer policies, coverage criteria, and product information to ensure a superior patient experience.
• Ensure adherence to Baxter and payer policies while maintaining high standards of quality and compliance.
• Seek learning opportunities and support workload coverage; perform additional duties as assigned.

Skills

RN/RT/LPN

Strong communication

Multitasking

Microsoft Office

Education

Associate degree

Tools

Microsoft Office

Job description

Baxter is seeking a Clinical Appeals Advocate to support patients denied insurance coverage for Respiratory Health products. You will work with patients, healthcare teams, and payers to overturn denials and secure access to medically necessary therapies, advancing our mission to Save and Sustain Lives.

This role requires clinical understanding, excellent communication, and the ability to navigate complex payer policies.