Seeking an experienced Registered Nurse to review denied claims, determine medical necessity, and prepare strong clinical appeals. This role partners closely with clinical teams, hospitals, and patient advocacy staff to ensure accurate, timely, and compliant appeal submissions.
Responsibilities
Review clinical records and write medical necessity appeals
Collaborate with field clinicians to resolve documentation gaps
Request and organize supporting medical records
Communicate with hospitals and patient advocacy teams
Ensure compliance with payer, state, and federal guidelines
Track trends, identify issues, and support quality initiatives
Requirements
Active Arizona RN license (required)
A minimum of 3+ years RN clinical experience
Associate's or Bachelor's Degree in Nursing (ASN/BSN)
Air Ambulance, Critical Care, or ER experience.
A minimum of 2 years of claims review or appeals-writing experience
Strong communication skills and ability to manage high-volume work
High attention to detail and strict adherence to HIPAA
Salary: 70K-105K/yr + $7,500 Sign-On Bonus
Comprehensive Benefits including medical, dental, vision, life insurance, disability, legal services, pet insurance & more. Tempe, AZ 85288 (onsite)
Pay Details: $70,000.00 to $105,000.00 per year
Search managed by: Joanna Calderon
Equal Opportunity Employer/Veterans/Disabled
Military connected talent encouraged to apply
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The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
The California Fair Chance Act
Los Angeles City Fair Chance Ordinance
Los Angeles County Fair Chance Ordinance for Employers
San Francisco Fair Chance Ordinance
Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.