Clinical Appeals Specialist

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Requirements:

• Strong background in clinical denial strategies, with hands-on experience in creating and refining appeal letters.
• Solid understanding of the clinical denial landscape and experience in leading teams.
• Previous experience or strong interest in advising healthcare technology companies.
• Medical degree (RN or MD) with clinical and/or appeals background.

Responsibilities:

• Review and refine technology-generated Clinical Denial Appeal letters, ensuring compliance with best practices.
• Collaborate with cross-functional teams to develop and standardize clinical denial strategies.
• Oversee the quality control process for appeal documentation, ensuring consistency.
• Provide insights and recommendations that influence product development.
• Possibly contribute to the product strategy and work with the technology team to enhance appeal processes.