Clinical Appeals Specialist (LVN)

TEKsystems • San Bernardino, CA

16d • $26 - $30 • Onsite

About The Position

We are seeking a dedicated Clinical Appeals Nurse to join our Revenue Cycle Management team. The ideal candidate will be responsible for managing clinical denials related to medical necessity, level of care, and delays in service. This role involves reviewing medical records, preparing clinical documentation to support appeals, and following up on submitted appeals. The Clinical Appeals Specialist will work closely with a team of Licensed Vocational Nurses (LVNs) and Registered Nurses (RNs) to ensure comprehensive and accurate appeal submissions.

Requirements

• 1+ Years of experience in reviewing medical records
• 1+ years of experiences in appeals and denials
• High School Diploma
• clinical data analysis
• appeals
• medical reimbursement
• clinical review
• collections medical

Responsibilities

• managing clinical denials related to medical necessity, level of care, and delays in service
• reviewing medical records
• preparing clinical documentation to support appeals
• following up on submitted appeals
• work closely with a team of Licensed Vocational Nurses (LVNs) and Registered Nurses (RNs) to ensure comprehensive and accurate appeal submissions

Benefits

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

What This Job Offers

• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees