Sr Nurse External Appeal Reviewer

Brigham and Women's Faulkner Hospital

Base: $79,560.00 - $115,720.80/annual; bonus/equit...
Fully remote
Strong appeal writing experience
Interpret clinical data and identify trends
Proficient in electronic health record systems
Brigham and Women's Faulkner Hospital is seeking a Senior Nurse External Appeal Reviewer to coordinate and facilitate clinical charge audits and appeals processes. The ideal candidate should have a nursing background, experience in quality assurance, and strong skills in appeal writing and data analysis

Job Summary

  • The Senior Nurse Reviewer is responsible for coordinating audits and defending complex charge and forensic audit findings to preserve appeal rights.
  • This role requires strong analytical skills to interpret clinical data and identify trends while utilizing EHR systems for documentation.
  • Mass General Brigham offers a competitive annual salary range of $79,560.00 to $115,720.80 along with comprehensive benefits and career advancement opportunities.

Matching Summary

Match Score: 85

Brigham and Women's Faulkner Hospital is seeking a Senior Nurse External Appeal Reviewer to coordinate and facilitate clinical charge audits and appeals processes. The ideal candidate should have a nursing background, experience in quality assurance, and strong skills in appeal writing and data analysis.

Salary

Base: $79,560.00 - $115,720.80/Annual; Bonus/Equity: Not specified; Benefits: Comprehensive benefits, career advancement, differentials, premiums, bonuses

Skills & Requirements

Must-have

  • Strong appeal writing experience
  • Interpret clinical data and identify trends
  • Proficient in electronic health record systems

Nice-to-have

  • Excellent communication and interpersonal skills
  • Ability to provide constructive feedback
  • Collaborate effectively with multidisciplinary teams

Key Requirements

  • Bachelor's Degree in Nursing required
  • Registered Nurse license in Massachusetts
  • 3+ years of clinical nursing experience
  • 2+ years in quality assurance or clinical review

Work Rights

Not specified

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