Top 5 Appeals nurse Jobs in Indianapolis, In

Registered Nurse
RADcube —Carmel, IN
- Remote
- Microsoft Outlook
- RN License
- Research
Case Manager-PRN
Indiana University Health —Indianapolis, IN
- Part-time
- Acute care
- Nursing
- RN License
Managed Care Specialist (RN/LPN)
Brickyard Healthcare —Indianapolis, IN
- RN License
- Mid-level
- LPN
- Health insurance
- Dental insurance
Quick Apply
RN Case Manager
Indiana University Health —Avon, IN
- Full-time
- Nursing
- RN License
- Hospital
- Wellness program
- Tuition reimbursement

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Case Manager-PRN
Indiana University Health —Indianapolis, IN
Active RN license in Indiana or Nurse Licensure Compact (NLC). Active RN license in Indiana or Nurse Licensure Compact (NLC). Position: RN - Case Manager - PRN.
ZZZCase Manager II PRN
Kindred Hospital Indianapolis North —Indianapolis, IN
BSN preferred; or MSW/BSW with licensure as required by state regulations. Healthcare professional licensure required as Registered Nurse, or Licensed Clinical…

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Denials RN Coordinator
Ensemble RCM LLC —Columbus, OH
Extensive review of medical records for medical necessity criteria, filing written letters of appeal on denied claims, filing complaints with state Department…
$62,500 - $79,800 a year
2d
Registered Nurse
Cimarron Aesthetics —New Albany, OH
Answer incoming telephone calls, text messages and patient inquiries professionally and promptly. Responsibilities will include answering phones and text…
$60,000 - $80,000 a year
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3d

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appeals nurse jobs near indianapolis, in

Registered Nurse

RADcube -
Carmel, IN

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Job Details

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Full Job Description

Job Title: Registered Nurse Clinical Auditor - Junior
Location: Remote with Occasional travel - Downtown Indianapolis, IN

We are seeking a detail-oriented Registered Nurse to support medical record reviews, billing compliance audits for the Indiana Health Coverage Programs. This role is responsible for evaluating quality of care, reviewing medical records and program policies and identifying compliance issues, preparing audit documentation and reports, and supporting appeals activities. The ideal candidate brings clinical knowledge, regulatory awareness, and strong analytical and writing skills. This is a remote position with occasional travel required within Indiana.

Key Responsibilities

Review medical records and related documentation to evaluate provider compliance with Indiana Health Coverage Programs, CMS, AMA, and other applicable standards and regulations.
Conduct medical record and compliance reviews independently and provide preliminary findings to the Lead Reviewer.
Identify potential documentation deficiencies, and billing compliance issues.
Maintain detailed workpapers documenting procedures performed, records reviewed, findings identified, and conclusions reached.
Assist with audit responses and appeals as needed.
Ensure all work aligns with state, federal, and national healthcare and Medicaid guidelines.
Stay current on clinical guidelines, policies, regulations, and Indiana Medicaid program and policy updates.
Research Indiana Medicaid rules and maintain internal repositories of bulletins, policies, and procedures.
Adapt quickly to changing priorities, policies, regulatory updates, and review requirements while maintaining accuracy and meeting deadlines.

Qualifications

RN license preferred; Indiana license or compact license accepted.
Coding certification such as CCS or CPC are strongly preferred.
Candidate located in or near the Indianapolis area are preferred.
At least 1 year of Medicaid claims review, billing compliance, or healthcare reimbursement experience.
Familiarity with Indiana Medicaid policies, payer guidelines, and documentation requirements preferred.
Knowledge of CPT coding guidelines and ICD-10 standards.
Proficiency in Microsoft Excel, Word, and Outlook.
Strong analytical, critical thinking, problem-solving, and technical writing skills.
Ability to work independently and collaboratively in a fast-paced environment.
Experience working with healthcare providers is strongly preferred.
Knowledge of healthcare claims data and fraud, waste, and abuse preferred.

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appeals nurse jobs in indianapolis, in

Registered Nurse

Case Manager-PRN

Managed Care Specialist (RN/LPN)

RN Case Manager

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