Remote Clinical Denials & Appeals Coordinator

WVU Medicine; Morgantown (WV); On-site; USD 52,000 - 65,000; Part time

Job summary

West Virginia University Health System in Morgantown, WV is seeking a Clinical Denials Coordinator to report, monitor, and analyze insurance denials and coordinate appeals with payers. This role requires RN licensure and 3 years of healthcare experience, with preferred BSN or ASN.

You will lead denial management activities and support revenue cycle leadership. The position focuses on writing clinical appeal letters, auditing records for denials, and collaborating with Case Management, Payer

Qualifications

• Current RN license in the state or multi-state license via eNLC.
• Three years of healthcare clinical experience.
• Bachelor's degree in Nursing or ASN/ diploma; BSN preferred or in progress.

Responsibilities

• Completes clinical appeal writing for insurance denials.
• Evaluates medical records for denial-related discrepancies.
• Calculates dollar amounts and submits adjustments.
• Negotiates with payers and provides supporting documentation.
• Maintains denial database and coordinates with Case Management.
• Presents education and training on denial management.

Skills

Letter writing

Clinical knowledge

Communication skills

Education

RN license

Job description

West Virginia University Health System in Morgantown, WV is seeking a Clinical Denials Coordinator to report, monitor, and analyze insurance denials and coordinate appeals with payers. This role requires RN licensure and 3 years of healthcare experience, with preferred BSN or ASN.

You will lead denial management activities and support revenue cycle leadership. The position focuses on writing clinical appeal letters, auditing records for denials, and collaborating with Case Management, Payer