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Ascension Saint Thomas Rehabilitation Hospital is proud to be recognized by Newsweek as one of America’s Best Rehabilitation Hospitals in 2024. A career at Ascension Saint Thomas Rehabilitation Hospital, a 40-bed inpatient rehabilitation hospital operated jointly between Ascension Saint Thomas and Lifepoint Health, is more than a job. It is an opportunity to be a vital member of an interdisciplinary team caring for people in Nashville, providing high-quality inpatient rehabilitation services designed to help patients with acute physical limitations as they progress toward independent living. You have specialized skills and our patients need them! If you are an enthusiastic individual seeking an environment dedicated to superior patient care and an organization with a strong mission to serve our community, we invite you to apply!

Clinical Appeals Liaison

Nashville, Tennessee

Req ID 530206 Post Date Dec. 16, 2024 CategoryNon-Clinical FacilityAscension Saint Thomas Rehabilitation Hospital
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Description

What you will do in this role:

  • Review denied insurance claims for medical treatment, thoroughly analyzing patient medical records to determine if the denial was justified
  • Prepare comprehensive appeals packages including detailed clinical narratives and necessary supporting medical records, for presentation to insurance companies to substantiate and advocate for patient access to necessary care, utilizing their clinical expertise to support the medical necessity of requested services
  • Initiate appeal letters and briefs for denials
  • Ensures all appeals are completed within established timelines and in accordance with regulatory and contractual requirements
  • Other duties as assigned


Qualifications

  • Must be licensed as a RN, LPN/LVN, PT, or OT
  • Minimum of 2 years on Inpatient Rehabilitation Hospital experience
  • Minimum 3 years of clinical experience
  • Excellent oral and written communication and interpersonal skills
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