Sr Nurse External Appeal Reviewer

Mass General Brigham Incorporated

United States
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
Mass General Brigham is seeking a Senior Nurse External Appeal Reviewer to coordinate and facilitate clinical audits and appeals processes. The ideal candidate will have a nursing background, strong analytical and communication skills, and experience in quality assurance or clinical review

Job Summary

  • The Senior Nurse Reviewer is responsible for coordinating audits and defending clinical charge findings to preserve appeal rights.
  • This role requires strong analytical skills to interpret clinical data and identify trends within complex charge and forensic audits.
  • The position offers a competitive base pay range of $79,560.00 to $115,720.80 annually along with comprehensive benefits.

Matching Summary

Match Score: 85

Mass General Brigham is seeking a Senior Nurse External Appeal Reviewer to coordinate and facilitate clinical audits and appeals processes. The ideal candidate will have a nursing background, strong analytical and communication skills, and experience in quality assurance or clinical review.

Salary

Base: $79,560.00 - $115,720.80/Annual; Bonus/Equity: Not specified; Benefits: Comprehensive benefits, career advancement, differentials, premiums, and 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
  • Facilitate training for nursing staff

Key Requirements

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

Work Rights

Not specified

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