RN Appeals Coordinator

Are you a detail-oriented Registered Nurse with a strong understanding of reimbursement processes and a passion for advocacy? Join Elderwood Administrative Services as an RN Appeals Coordinator and play a key role in ensuring accurate and timely resolution of Medicare and Insurance appeals and denials across our growing network of senior care communities.

Elderwood is a recognized leader in senior care across the Northeast, offering a full continuum of services including independent living, assisted living, skilled nursing, subacute rehab, memory care, and more. We pride ourselves on quality care, exceptional outcomes, and supportive services to residents and employees alike.

Position Overview:

• As the RN Appeals Coordinator, you'll manage the appeals and denials process for Medicare and Insurance claims across Elderwood's portfolio. This is a critical role that blends clinical expertise with strong organizational, documentation, and communication skills.

RN Appeals Coordinator:

• Coordinate and track all Medicare and Insurance documentation and/or refund requests, appeals and/or denials.
• Communicates with billing departments, regional reimbursement and rehab teams to coordinate efforts for responding to requests in a timely fashion.
• Conduct site visits to review records prior to submitting.
• Provide feedback to facility staff regarding areas of potential improvement. Record all appeals activity and trend patterns identified if applicable.
• Communicate with central billing regarding outstanding or paid accounts.
• Provide updates to team regarding status of outstanding accounts.

RN Appeals Coordinator:

• Minimum of RN Associate Degree
• Long Term Reimbursement and RAC Certification a plus
• Knowledge of MDS and RUGs as well as minimum of 2 years in long term clinical experience