RN Appeals Writer – RAC for Home Health and Hospice
Piedmont Healthcare · United States · US
Utilization Review
Remote
Nurse
Demand72
Career growth63
Healthcare fit74
Remote potential55
5-year outlook
Appeals and utilization review nursing roles tend to pay at or above bedside RN rates, with a premium for RAC/denial-management expertise. Growth is steady but tied to payer audit volume and regulatory change rather than rapid expansion; advancement typically moves toward UR leadership, compliance, or revenue cycle management.
Clinical license
Required
Applicant reach
narrow
Seniority
senior
Employment type
full-time
Date found
2026-09-28
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- Nurse
- Rate period
- Annual
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth considering for experienced nurses who want to leave bedside care and move into payer-facing, documentation-heavy work with a stable health system employer. The 7-year experience and auditing requirements make it a poor fit for newer nurses or non-RN clinicians.
Who should apply
Experienced RNs with 5-7+ years in acute care, home health, or hospice who have done utilization review, case management, or medical necessity chart auditing. Nurses familiar with InterQual/Milliman criteria and EPIC who want a non-bedside, regulatory-focused career path.
CV angle
Lead with RN licensure and years of clinical experience, then reframe charting and care coordination work as medical record review and clinical documentation. Quantify any utilization review, denial, or appeals exposure, and explicitly name InterQual, Milliman, EPIC, and medical necessity criteria. Highlight any experience writing clinical summaries, justifying level of care, or interfacing with payers — these map directly to appeals narrative drafting.
Skills to highlight
- Clinical documentation and narrative writing
- Medical necessity determination
- Utilization review (InterQual/Milliman)
- Medical record auditing
- Medicare/Medicaid regulatory knowledge
- EHR proficiency (EPIC, SCM/Quest, STAR, I-Suites)
- Denial and appeals management
- Cross-functional collaboration with legal/compliance
Role summary
An RN Appeals Writer at Piedmont Healthcare reviews patient medical records, extracts clinical evidence, and drafts Medicare/Medicaid appeal narratives for denied home health and hospice cases across all levels of the government appeals process. The role requires deep knowledge of medical necessity criteria, utilization review regulations, and coding, and may involve supporting or testifying in ALJ hearings.
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