Clinical Appeals Nurse — Payor Denials Specialist

Grady Health System in Atlanta, GA seeks a Clinical Appeals Nurse to evaluate payor denials and level of care status downgrades, and to compose informed appeals to overturn denials. The role relies on RN clinical experience and familiarity with utilization review criteria such as InterQual, with strong written and verbal communication.

The nurse will track appeals in Epic, report success rates by payor, and collaborate with Care Management and Revenue Strategy to improve processes and reduce