RN Denials & Appeals Specialist – Hybrid, Day Shift

Atlantic Health System; Morristown (NJ); Hybrid; USD 69,000 - 122,000; Full time

Job summary

Atlantic Health System invites a Hospital Appeals Specialist (RN) to join Morristown, NJ. This full-time day hybrid role reports to the Denials Manager and focuses on clinical review of denied services, preparing appeal letters, and driving in-house denial workflows.

You will collaborate with revenue cycle leaders to identify root causes of denials and help establish an in-house appeals department while ensuring timely submission and maximum reimbursements.

Qualifications

• Active NJ RN license required.
• BSN preferred.
• 3-5+ years of clinical experience (acute care preferred).

Responsibilities

• Complete clinical review of denied services and prepare appeal letters for payers.
• Develop denials workflows and work toward establishing an in-house appeals department.
• Identify root causes of denials and establish relationships with Atlantic Health leaders.
• Manage department workflows, ensure timely submission and follow-up of denied claims.
• Analyze EOBs to understand payor explanations of benefits across non-governmental claims.
• Provide monthly denial reports to department manager and stakeholders.

Skills

Denials management

Clinical review

Education

NJ RN license

BSN preferred

3-5+ years clinical experience (acute care)

Job description

Atlantic Health System invites a Hospital Appeals Specialist (RN) to join Morristown, NJ. This full-time day hybrid role reports to the Denials Manager and focuses on clinical review of denied services, preparing appeal letters, and driving in-house denial workflows.

You will collaborate with revenue cycle leaders to identify root causes of denials and help establish an in-house appeals department while ensuring timely submission and maximum reimbursements.