Clinical Appeals Specialist
Rhode Island Hospital(3 months ago)
About this role
The Clinical Appeals Specialist is a mid-level clinical role at Brown University Health within Patient Financial Services, supporting the hospital system's appeals and audit efforts across affiliated sites. The position reports to the Manager of Appeals and works collaboratively with internal departments and external payers in a hybrid work setting.
Required Skills
- Medical Records
- Appeals Management
- Utilization Review
- InterQual
- CMS Guidelines
- Data Analysis
- Audit Reporting
- Clinical Assessment
- Presentation
- Collaboration
Qualifications
- Bachelor's Degree in Nursing
- Master's Degree Preferred
- Registered Nurse License (RI)
- Nurse Licensure Compact
About Rhode Island Hospital
lifespan.orgLifespan is now Brown University Health. Our name may have changed, but our commitment to the highest-quality patient care has not.
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