RN Denial Mitigation & Appeal Specialist II

Baptist; Memphis (TN); On-site; USD 70,000 - 90,000; Full time

Job summary

Baptist is seeking an experienced Denial Mitigation-Appeal Specialist II RN to support revenue cycle efforts by reviewing clinical records, preparing appeals, and coordinating with payers to maximize reimbursements.

The role requires extensive payer guidelines knowledge, strong writing and communication skills, and the ability to work with physicians and coding/billing teams. Remote work may be possible after probation based on productivity.

Qualifications

• RN with clinical experience in acute care settings.
• Experience in denial management, authorizations, or medical review.
• Familiarity with electronic medical records and claims systems.

Responsibilities

• Review clinical information and documentation to determine appeals.
• Prepare clinical timelines and summaries for post-claim denials.
• Submit appeals and communicate with payers and physician offices.
• Collaborate with coding/billing and escalate as needed to management.
• Monitor denial trends and support process improvements.
• Potentially participate in payer hearings or clinical meetings.

Skills

Interpersonal skills

Written communication

Verbal communication

Analytical thinking

Computer literacy

Data interpretation

Typing speed

Education

Graduate of an accredited nursing program

Job description

Baptist is seeking an experienced Denial Mitigation-Appeal Specialist II RN to support revenue cycle efforts by reviewing clinical records, preparing appeals, and coordinating with payers to maximize reimbursements.

The role requires extensive payer guidelines knowledge, strong writing and communication skills, and the ability to work with physicians and coding/billing teams. Remote work may be possible after probation based on productivity.