Denial & Appeals Coordinator, RN, Concurrent Denials Prevention, FT, 08:30A-5P

This role serves as a senior expert consultant for Case Management, ensuring high-quality patient care, appropriate length of stay, and efficient resource utilization through the application of regulatory and national guidelines. The position involves evaluating denials and non-certified days from third-party payors, formulating appeals, and acting as a liaison between the hospital and various external entities like CMS and eQ Health. The coordinator also reviews surgery cases to ensure appropriate coding, authorization, and medical necessity are documented in the EMR prior to billing.