Location
Richmond
Job Type
FULL_TIME
Posted
July 08, 2026
Job Description
Responsibilities
Perform clinical reviews in response to claim denials by third party payers Analyze medical records to confirm medical necessity as it pertains to inpatient level of care, readmissions, patient length of stay, non-covered services, experimental and investigational issues, ER Downgrades, DRG validation and other claim denials. Draft detailed clinical appe...
Atlantic Region CBO:
The Atlantic Region Central Billing Office (“ARCBO”) or (“CBO”) provides business office services including billing, collections, cash posting, pre-access management, variance, and customer service to our affiliated Universal Health Services hospitals.
The Atlantic Region CBO is seeking a dynamic and talented Appeals Nurse with clinical case management experience, to analyze clinical claim denials, draft detailed appeal letters, evaluate clinical level of care and review denial trends.
Key Responsibilities include: