Johns Hopkins Intrastaff is the internal staffing agency for the Johns Hopkins Health System and partner hospitals, providing temporary support to a variety of the Johns Hopkins locations. Our employees are the strength of our service. Intrastaff is unique because it's one of the very few agencies where a person has the benefit of being a temporary employee and also feels like a member of a large organization. Working at Hopkins means joining a culturally diverse team that includes some of the best nurses, physicians and allied health professionals in the world. Directly or indirectly, you'll have exposure to cutting-edge technology and groundbreaking medical research. The Appeals Nurse Analyst is responsible for the timely resolution of clinical appeals as received from providers and members for all lines of business managed by JHHC. Full time, day shift, 8-4:30pm The Appeals Nurse Analyst position is responsible for timely resolution of clinical appeals as received from providers and members for all lines-of-business managed by JHHC. This individual will be responsible for: Reviewing provider and member appeals based on situations and making appropriate determination based on documentation presented by appealing agent with references to federal, state and local regulations as well as JHHC policy and procedures . Communicating resolutions to appellant as required. Providing resources to non-clinical staff in review of administrative denials or appeals involving coding disputes.Tracking appeals on logs, databases and other data as appropriate. RN license in MD. Demonstrated knowledge in the health field as acquired during three years of acute care nursing experience. Knowledge of Interqual Milimen & Roberts or other UR tools. Knowledge of ICD-9, CPT-4 and revenue coding and managed care case management beneficial. Excellent interpersonal skills, self-motivated, team player, organized, good typing skills, MS Word, med/surg office skills. Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.