(Remote – U.S.)
🧾 About the Role
WVU Medicine is seeking a Clinical Denial Coordinator to manage and lead appeals for denied medical claims. This full-time, remote role combines clinical expertise with sharp analytical and writing skills to recover revenue and improve internal processes. You’ll work across teams to craft appeal letters, investigate payer denials, and champion system-wide improvements in documentation and billing accuracy.
✅ Position Highlights
• Schedule: 40 hours/week
• Employment Type: Full-Time
• Location: Remote (U.S.-based)
• Department: Clinical Denial Management
• Status: Exempt (salaried)
• Req ID: JR25-10925
• Posted: 9 days ago
📋 What You’ll Own
• Draft compelling appeals for denials from RAC, Medicaid RAC, and other payers
• Review patient records to ensure billing accuracy and proper documentation
• Identify and correct under- or over-billed charges
• Collaborate with auditors using supporting clinical evidence to resolve disputes
• Track, enter, and analyze denial correspondence
• Partner with Case Management, Access, and providers for appeals support
• Lead training and educational sessions around denial trends
• Recommend solutions based on root cause analysis
• Maintain and distribute regular denial reports
🎯 Must-Have Traits
• Active RN license (state-based or compact via eNLC)
• At least 3 years of clinical healthcare experience
• Familiarity with payer guidelines, medical necessity rules, and CPT/LCD/NCD coding
• Strong clinical judgment and attention to detail
• Excellent written communication and persuasive appeal writing
• Independent worker with strong negotiation skills
💻 Remote Requirements
• Reliable high-speed internet
• Private, secure home office setup
• Able to manage PHI in full compliance with HIPAA
💡 Why It’s a Win for Remote RNs with Auditing or Appeals Experience
• Leverage your clinical knowledge without bedside demands
• Support patient care and hospital revenue integrity from home
• Work with the largest healthcare system in West Virginia
• Be part of a team focused on precision, compliance, and improvement
• Make a direct impact on reimbursement outcomes and operational success
✍️ Call to Action
If you’re an RN with a keen eye, a way with words, and a passion for doing right by patients and providers, this is your lane. Apply now to join WVU Medicine as a Clinical Denial Coordinator and take ownership of getting claims right.