Registered Nurse or Licensed Practical Nurse, Home Health and Hospice Medical Review & Appeals
Employment type
Full-time
Work setting
Hybrid
Location
Sandy, UT
Schedule
Day shift
Posted
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Job overview
The Home Health and Hospice Medical Review and Appeals Specialist role is hybrid, with 90% remote work and 10% in the Sandy, UT office. Compensation is not specified. The specialist supports home health and hospice services by strengthening documentation and reimbursement processes. The role manages medical reviews, documentation requests, and payer appeals to support medical necessity and regulatory compliance. By reviewing clinical records, preparing appeals, tracking outcomes, and partnering with clinicians and billing and compliance teams, the specialist helps reduce denials and improve documentation practices.
What you'll do
- Manage pre-claim, post-payment, and audit-related reviews with the lead specialist
- respond to payer documentation requests and reviews
- assess clinical records for payer and regulatory requirements
- prepare appeal letters and supporting documentation
- track appeal cases and outcomes
- identify denial trends
- educate clinicians on documentation practices
- coordinate with billing, coding, and compliance teams
- help develop workflows, templates, and tools.
What we're looking for
- Skills & competencies
- home healthhospicemedical reviewpayer appealsregistered nurselicensed practical nursehybrid remotesandy utadvanced home health and hospiceclinical documentationregulatory compliancemedicare and medicaid
- Work arrangement
- Weekend coverage required
Benefits & perks
- Medical, dental, and vision insurance
- FSA and HSA options
- short- and long-term disability
- voluntary life insurance
- insurance discounts
- 401(k) with company match
- theater perks.
Why this role
Requires an active RN or LPN/LVN license and at least three years of home health or hospice clinical experience; utilization review, compliance, or payer appeals experience is preferred.
About the employer
Advanced Home Health and Hospice is hiring for this role. Industry: Home Health Care Services. Sector: 62.
Additional details
- Industry sector
- 62
- Industry
- Home Health Care Services
- Occupation code
- 29-1141.00
You'll be redirected to the employer's application page.
Listing ID: 929c9bde-e7fc-4952-b60f-4179adfba7cc