RN Licensed Clinical Appeals Supervisor

Overseeing the coordination of audit and medical necessity denial appeals, the full-time remote RN Licensed Clinical Appeals Supervisor will manage a team to ensure timely submissions, compliance with regulatory standards, and the achievement of service goals while providing leadership and developing standardized processes. Key Responsibilities Supervises the team in reviewing, preparing, and submitting medical necessity denial appeals according to established processes Ensures timely communication with auditors and manages documentation requests and appeal submissions Monitors team performance for compliance with regulatory requirements and provides training on appeals processes Required Qualifications H.S. Diploma or GED required Associate Degree in Nursing, Healthcare Administration, or a related field preferred 3-5 years of experience in healthcare appeals or denials management required 1-2 years of leadership or supervisory experience preferred RN - Registered Nurse - State Licensure and/or Compact State Licensure preferred