Tennessee Licensed RN Appeals Analyst

A company is looking for an RN Appeals Analyst to perform clinical reviews and benefit analyses for appeal requests. Key Responsibilities Document appeals and retrospective reviews accurately and timely in compliance with regulations Conduct thorough research on service appeals based on clinical documentation and contractual requirements Perform special projects to identify quality of care issues through clinical information reviews Required Qualifications Associate's degree in a job-related field or equivalent from an accredited nursing school 2 years of clinical experience plus 1 year of utilization/medical review, or 3 years of clinical experience Active, unrestricted RN license in the state of hire or compact multistate RN license Working knowledge of managed care and health care delivery systems Proficiency in Microsoft Office software

Created: 2026-03-05