Remote Hospital Clinical Appeals Nurse – Maryland Healthcare Review RN

Remote Hospital Clinical Appeals Nurse – Maryland Healthcare Review RN

Company: Chesapeake Healthcare Review Partners

Location: Maryland, United States (Remote)

Chesapeake Healthcare Review Partners is seeking an experienced Clinical Appeals Nurse RN to support healthcare appeal reviews, clinical documentation analysis, and medical necessity evaluations. This remote nursing position helps healthcare organizations respond to complex insurance and authorization decisions.

The Clinical Appeals Nurse reviews medical records, analyzes clinical information, and prepares accurate documentation to support healthcare appeal submissions.

Responsibilities

• Review denied healthcare service cases
• Analyze medical records and clinical documentation
• Prepare clinical appeal summaries
• Evaluate medical necessity information
• Collaborate with physicians and healthcare teams
• Maintain accurate review documentation
• Support appeal submission processes
• Apply healthcare guidelines and policies

Qualifications

• Active Registered Nurse (RN) license
• Clinical nursing experience required
• Experience with utilization review preferred
• Strong clinical documentation skills
• Excellent written communication abilities
• Knowledge of healthcare regulations

Preferred Experience

• Clinical appeals
• Utilization management
• Insurance review
• Hospital case management

Technology Used

• Electronic health records
• Clinical review platforms
• Healthcare authorization systems
• Document management software

Schedule

Full-time remote nursing position with weekday business hours.

Benefits

• Medical Insurance
• Dental Insurance
• Vision Insurance
• 401(k) Retirement Plan
• Paid Time Off
• RN Certification Support
• Continuing Education Benefits
• Annual Performance Bonus
• Remote Technology Package

Why Join Chesapeake Healthcare Review Partners?

Chesapeake Healthcare Review Partners provides expert clinical review services that help healthcare organizations improve decision-making and patient access. Our remote nurses use their clinical expertise to support better healthcare outcomes.

Chesapeake Healthcare Review Partners is an Equal Opportunity Employer. Applicants from Baltimore, Bethesda, Rockville, Columbia, Annapolis, and communities throughout Maryland are encouraged to apply.