Clinical Appeals RN Cover Letter

Clinical Appeals RN Cover Letter

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15 Clinical Appeals RN cover letter templates

What to include in a Cover Letter
1
Company Address
2
Salutation
3
Compelling Details
4
Respectful Closing

How to Write the Clinical Appeals RN Cover Letter

87477 Ronald Extensions
South Elmo, SD 83608
Dear Finley Conroy,

I submit this application to express my sincere interest in the clinical appeals RN position.

In my previous role, I was responsible for patients with all necessary notices in accordance with requirements for CMS conditions of participation and insurance payer contracts.

Please consider my experience and qualifications for this position:

  • Medi-Cal and/or Medicare experience/knowledge
  • Experience with commercial plans
  • Current, unrestricted license to practice as a Registered Professional Nurse in New York State
  • Proficient in Microsoft office – basics on Word, Excel and Outlook
  • Experience working in utilization management or appeals on the insurance side
  • Experience with Sunrise EMR
  • Nursing experience in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management/case management
  • CPC (coding certification)

Thank you in advance for taking the time to read my cover letter and to review my resume.

Sincerely,

Sam Weber

Responsibilities for Clinical Appeals RN Cover Letter

Clinical appeals RN responsible for real time feedback for corrections, coding clarifications and timeliness needed to show full compliance with CMS regulations and to maximize reimbursement.

Experience using standardized clinical guidelines
Proficient knowledge of Microsoft outlook and word
Experience using MCG and/or Medicare criteria
Understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual or Medicare Guidelines
Processes appeals and grievances within NYS and federal regulatory time frames, which could be standard (long period of time) or expedited (3 day turnaround)
Collaboratives with other departments to thoroughly investigate all appeals and grievances from denial of treatment to quality of care issues
Prepares for and participates in regulatory site visits
Experience in Appeals and / or Utilization Management

Clinical Appeals RN Examples

Example #1

Example of Clinical Appeals RN Cover Letter

19082 Angila Ports
Blockborough, CT 13917-4967
Dear Stevie Rath,

I submit this application to express my sincere interest in the clinical appeals RN position.

In the previous role, I was responsible for updates on CMS changes and AMA / CPT changes and ensure implementation, as well as attending annual AMA code update meeting to understand all coding changes.

Please consider my experience and qualifications for this position:

  • Previous Utilization Review experience is preferred
  • Experience with InterQual system preferred
  • HHA and / or PCA experience
  • Experience with prior authorization, utilization management or clinical appeal review
  • Medicaid population
  • Reside in a nurse compact licensure state
  • Preferred location 1101 Greenwood Avenue location, Lake Mary, Florida
  • Demonstrated understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual, Milliman or Medicare local coverage guidelines

Thank you in advance for taking the time to read my cover letter and to review my resume.

Sincerely,

Ryan Von

Example #2

Example of Clinical Appeals RN Cover Letter

4927 Rafael Glen
Faustoton, WA 51181-8503
Dear Rowan Wintheiser,

I am excited to be applying for the position of clinical appeals RN. Please accept this letter and the attached resume as my interest in this position.

Previously, I was responsible for support to all units within CR&R to ensure Star Ratings are not jeopardized and all clinical components are met for CMS, NCQA, URAC, DOL, DOI, and all other State and Federal entities.

Please consider my qualifications and experience:

  • Critical thinking, astute assessment and confident in decision making
  • Knowledge of Interqual, MCG, or equivalent criteria and reimbursement guidelines
  • Use of Microsoft Office including Word, Excel, and Power Point
  • Use of EPIC
  • Experience dealing with coding and claim edits
  • Registered Nurse with active RN license in State of PA
  • Organized and demonstrates excellent team management skills
  • Claim review processes and workflow

I really appreciate you taking the time to review my application for the position of clinical appeals RN.

Sincerely,

Baylor Zieme

Example #3

Example of Clinical Appeals RN Cover Letter

530 Eldon Knoll
Schummview, IL 70696
Dear Lennox Goodwin,

I would like to submit my application for the clinical appeals RN opening. Please accept this letter and the attached resume.

In my previous role, I was responsible for education to all appropriate staff to insure compliance with the regulations and protocols for MDS 3.0 accuracy in coding, CMS updates and relevant changes.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

  • Intermediate Other Knowledge and proficiency in utilization criteria such as Interqual, MCG (Millimen), CPG
  • Knowledge of medical terminology, Current Procedural Terminology (CPT), and International Classification ofDisease (ICD)
  • Experience with Northern Light Health patient accounting software is preferred
  • Assist in maintaining a work environment free from recognized hazards that create a risk or injury to employees, patients, or visitors
  • Ergonomic evaluations are completed as needed
  • When appropriate, assist and support with the return of all workers with work related injuries and illness to gainful employment
  • North Carolina residency
  • Billing and Coding experience

Thank you for your time and consideration.

Sincerely,

Tatum Kassulke

Example #4

Example of Clinical Appeals RN Cover Letter

9189 Stewart Meadow
Port Richton, IA 13904
Dear Lennox Fadel,

I would like to submit my application for the clinical appeals RN opening. Please accept this letter and the attached resume.

Previously, I was responsible for knowledge and expertise related to third party government and non~government payer clinical denials and appeals processes.

Please consider my experience and qualifications for this position:

  • CPC or another Clinical Coding certification
  • Previous experience with InterQual system
  • Location – Phoenix
  • Current, unrestricted REGISTERED NURSE (RN) license in the State of CALIFORNIA (regardless of residency)
  • Appeals experience is strongly preferred
  • CPT, HCPC, ICD-9 and ICD-10 coding experience is strongly preferred
  • Previous experience in a telephonic or office based role
  • Maintains a positive attitude in a fast-paced environment

Thank you in advance for reviewing my candidacy for this position.

Sincerely,

Greer Armstrong

Example #5

Example of Clinical Appeals RN Cover Letter

85158 Ute Plaza
Bennieview, AK 28670
Dear Armani Blanda,

Please consider me for the clinical appeals RN opportunity. I am including my resume that lists my qualifications and experience.

In my previous role, I was responsible for position-specific training on ICD-10 coding and Risk Adjustment Methodology for staff members at the onset of the hiring process.

My experience is an excellent fit for the list of requirements in this job:

  • Clinical criteria and medical policy
  • Group process and team dynamics
  • Center for Medicare and Medicaid Services (CMS)
  • Interpersonal, verbal, and written communication
  • Independent & critical thinking
  • Microsoft Office (Word, Excel, Outlook) – Basic
  • Certified Professional Coder (CPC) and/or Certified Professional Coder – Hospital (CPH)
  • Prior experience as a pre-service or post-service clinical reviewer

Thank you for considering me to become a member of your team.

Sincerely,

Stevie Weissnat

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