Registered Nurse (RN), Clinical Appeals — Remote

Job overview

The Registered Nurse (RN), Clinical Appeals role is fully remote, with pay of $40–$50 per hour depending on experience. The team supports healthcare providers and hospital organizations with revenue cycle and accounts receivable services. The nurse applies clinical expertise to review insurance denials and prepare appeals involving authorization and medical necessity. Accurate, timely appeals and communication with providers and insurers support appropriate coverage decisions and denial-management outcomes.

What you'll do

• Review insurance denials and clinical appeals
• evaluate medical records and identify denial issues
• develop, prepare, and submit appeals within deadlines
• communicate and negotiate with insurance companies
• gather supporting documentation with team members
• maintain organized records
• track outcomes and success rates
• follow payer requirements, regulations, and HIPAA confidentiality requirements
• report outcomes and identify workflow improvements.

What we're looking for

Skills & competencies

registered nurse

clinical appeals

remote

insurance denials

medical necessity

prior authorization

utilization review

hipaa

trc talent solutions

$40–$50/hour

part-time or full-time

healthcare revenue cycle

Work arrangement

• Weekend coverage required

Why this role

Fully remote; part-time schedules of 20 hours per week or full-time schedules of 40 hours per week are available. Temporary role with potential to become permanent. Bachelor’s degree and at least two years of clinical experience required; appeals, prior authorization, utilization review, or case management experience is highly desirable.

About the employer

TRC Talent Solutions is hiring for this role. Industry: Employment Placement Agencies. Sector: 56.