Florida Licensed Clinical Appeals Nurse

Supporting revenue cycle operations, the remote Florida Licensed Clinical Appeals Nurse will review denied claims for clinical accuracy and medical necessity, develop evidence-based appeal strategies, and draft payer-ready appeal documentation. Key Responsibilities Review medical records and payer denial rationale to determine appeal opportunities Draft clear, concise, and evidence-based appeal letters for multiple levels of appeal Collaborate with coding, CDI, denial recovery, and operations teams to strengthen appeal strategy Required Qualifications Active Registered Nurse (RN) license in the United States Minimum 3-5 years of clinical nursing experience Strong understanding of medical necessity criteria and payer review processes Experience reviewing medical records and clinical documentation Excellent written communication skills for translating clinical information into persuasive appeal narratives