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RN Appeals & Utilization Review Specialist
Job in
Sterling Heights, Macomb County, Michigan, 48310, USA
Listed on 2026-07-07
Listing for:
Boston Medical Center
Full Time
position Listed on 2026-07-07
Job specializations:
-
Nursing
Clinical Nurse Specialist, RN Nurse
Job Description & How to Apply Below
Boston Medical Center is seeking an RN Appeal Administrator responsible for managing the pre-denial, denial, and appeal processes while ensuring compliance with medical necessity criteria. This role involves close collaboration with clinical teams and payers to secure necessary authorizations and optimize reimbursement.
The ideal candidate must have a Bachelor’s degree in Nursing, an active RN license in Massachusetts, and at least 5 years of relevant experience. Strong communication and leadership skills are essential for this position.
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