FREE ACCESS
5,000–10,000 jobs/day
See all jobs on JobTailor
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Denials & Appeals Administrator, RN
Boston Medical Center (BMC)RN Appeal Administrator overseeing pre-denial and appeal processes in healthcare settings. Collaborating with clinical teams to manage denials and ensure appropriate patient care steps.
Posted 6/16/2026full-timeRemote • Massachusetts • 🇺🇸 United StatesMid-LevelSenior💰 $4,303 - $6,250 per hourWebsite
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
medical necessity screeningpatient services authorizationmedical records codingclinical documentationmedical codingpatient financial billing regulationsreimbursementmanaged care
Soft Skills
interpersonal skillscommunicationcollaborationcoordinationevaluationresearchproblem-solving
Certifications & Qualifications
Bachelor's Degree in NursingLicensed to practice professional nursing in Massachusetts
Industry Keywords
healthcare case managementdenial managementpatient insurancebilling environment
About the role
Key responsibilities & impact- Responsible for the Pre-denial/ Denial and appeal process
- Validate placement of patients based on admission criteria
- Use medical necessity screening tools for reviews
- Secure authorization for patient services through collaboration with payers
- Assess, plan, coordinate, and evaluate initial and ongoing denials
- Research and respond to denials in a timely fashion
- Communicate with clinical team members to resolve denials
- Identify trends and recommend changes to reduce denials
Requirements
What you’ll need- Requires Bachelor's Degree in Nursing or related field
- Licensed to practice professional nursing in Massachusetts
- Minimum 5 years related experience in healthcare case management and patient insurance/billing environment. 3-4 years supervisory experience preferred.
- Medical records coding experience is desirable.
- Comprehensive knowledge of clinical documentation and medical coding
- Working knowledge of patient financial billing regulations/requirements, reimbursement, managed care
- Advanced interpersonal skills necessary to work with physicians, hospital directors, and managers
Benefits
Comp & perks- Health insurance
- Dental insurance
- Vision insurance
- Pharmacy benefits
- Discretionary annual bonuses
- Merit increases
- Flexible Spending Accounts
- 403(b) savings matches
- Paid time off
- Career advancement opportunities
- Resources to support employee and family well-being