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Clinical Appeals Rn Jobs (NOW HIRING)

MJHS

A&G RN Coordinator

Manhattan, NY · On-site

$110K - $120K/yr

The RN Coordinator will investigate and respond to written and/or verbal clinical appeals, expedited clinical grievances and potential quality of care grievances submitted by members and providers in ...

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How much do clinical appeals rn jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for clinical appeals rn in the United States is $38.55, according to ZipRecruiter salary data. Most workers in this role earn between $31.25 and $43.27 per hour, depending on experience, location, and employer.

What is a Clinical Appeals RN job?

A Clinical Appeals RN is a registered nurse who reviews denied medical claims and submits appeals to insurance companies to ensure appropriate reimbursement. They analyze medical records, insurance policies, and clinical guidelines to justify the necessity of treatments or procedures. This role requires strong knowledge of healthcare regulations, excellent critical thinking skills, and experience in case management or utilization review.

What does a typical day look like for a Clinical Appeals RN?

A typical day for a Clinical Appeals RN involves reviewing denied insurance claims, gathering and evaluating clinical documentation, composing argument letters, and communicating with healthcare providers and payers to support appeal cases. You may participate in multidisciplinary meetings to discuss complicated cases and must often manage multiple appeals at different stages of the process. The work is largely independent, though collaboration with physicians, case managers, and insurance representatives is common. Strong organization and time management skills are important to keep up with deadlines and ensure the best possible outcomes for patients.

What are the key skills and qualifications needed to thrive in the Clinical Appeals Rn position, and why are they important?

A Clinical Appeals RN requires current RN licensure, comprehensive clinical knowledge, and experience with utilization review or case management. Familiarity with healthcare claims, appeals processes, and specialized systems such as InterQual or Milliman, as well as strong documentation skills, are often essential. Excellent critical thinking, persuasive writing, and collaboration skills set top candidates apart. These skills ensure accurate, timely, and effective advocacy in the appeals process, leading to favorable outcomes for patients and healthcare organizations.

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What cities are hiring for Clinical Appeals Rn jobs? Cities with the most Clinical Appeals Rn job openings:
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Clinical Appeals Rn jobs near you
Infographic showing various Clinical Appeals Rn job openings in the United States as of July 2026, with employment types broken down into 90% Full Time, 8% Part Time, and 2% Contract. Highlights an 79% Physical, 5% Hybrid, and 16% Remote job distribution, with an average salary of $80,174 per year, or $38.5 per hour.
Appeal and Denial Specialist Carrollton TX

Appeal and Denial Specialist Carrollton TX

Continuum Rehab Group

Carrollton, TX • On-site

Full-time

Posted 20 days ago

Job description

) Requirement: Must be a LVN or RN with prior MDS experience. Prior experience with appeals, denials, and audits preferred.
This is NOT a Remote position. Must be located in the Dallas/Ft. Worth area as this is a Hybrid position based out of our Carrollton office.
Job Summary
Clinical Appeals & Revenue Specialist
Responsible for managing denied claims and payer audits, preparing and submitting appeal letters and medical records, reviewing clinical documentation for medical necessity, validating coding accuracy, identifying trends in denials, collaborating with MDS team and facility teams to improve outcomes, and ensuring compliance with Medicare, Medicaid, and commercial payer requirements. This position serves as the primary resource for revenue recovery through effective denial prevention, appeal management, and documentation integrity initiatives.
Key duties:
  • Review and analyze denied claims
  • Draft and submit appeal and reconsideration letters
  • Validate ICD-10, CPT, HCPCS, and coding as applicable
  • Support ADRs, UPICs, TPE, RAC, and payer audits
  • Track appeal outcomes and denial trends
  • Educate clinical staff on documentation deficiencies
  • Recover lost revenue through successful overturn of denials
  • Maintain compliance with payer and regulatory requirements

To submit your application for this role, please apply here or email your resume to melissa.collier@crgrehab.com
Continuum Rehab Group provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
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About Continuum Rehab Group

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To view all opportunities available with Continuum Rehab Group, please visit us atwww.crgrehab.com/jobs/

Industry

Health care and social assistance

Company size

51 - 200 Employees

Headquarters location

Carrollton, TX, US

Year founded

2019

Social media

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