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RN Clinical Denials Appeals Specialist
Company : Catholic Health Initiatives
Location : Centennial, CO
Job Type : Full Time
Salary : 35.17-56.1 HOUR
Date Posted : 3 January 2026
Job Summary and Responsibilities
You have a purpose, unique talents and now is the time to embrace it, live it and put it to work. We value incredible people with incredible skills – but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your success.
The RN Clinical Denials Appeals Specialist functions as a revenue management liaison for all care sites with external third-party payers to appeal denied claims and retrospectively identifies appeals
determination as indicated through research and coordination of completion of medical records and utilization review processes. Identifies areas for documentation and/or process improvement and promotes pro-active documentation compliance for reimbursement. Demonstrates dynamic ability to adapt to ongoing changes within the health insurance industry in order to effect and implement positive changes for financial growth.
Maintains knowledge of care guidelines related to severity of illness and risk of mortality, CMS rules, and insurance regulations. Accepts and completes projects as assigned. Communicates and collaborates with other departments and maintains active presence in inpatient and outpatient settings.
Job Requirements
In addition to bringing humankindness to the workplace each day, qualified candidates will need the following:
Required Education:
BSN required
Minimum Experience required:
4 years clinical experience as a Registered Nurse.
3 years with progressive experience in utilization review, preferred.
Prior experience writing clinical denial appeal letters required.
License Required:
Curent RN License in the State of employment
Physical Requirements
Medium Work - exert/lift up to 50 lbs. force occasionally, and/or up to 20 lbs. frequently, and/or up to 10
lbs. constantly
*Days/hours- Monday-Friday, 8am-5pm MST*
**This is a remote role. Primary residence must be in CO, UT, or Kansas.**
Must have Clinical Denials experience. Please make sure it's clearly written out in your resume.
Where You'll WorkWe believe in the healing power of humanity and serving the common good through our dedicated work and shared mission to celebrate humankindness.
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Frequently asked questions
This position plays a critical role in recovering denied claims by coordinating with payers and improving documentation processes, directly enhancing the financial health of healthcare providers in Centennial. Understanding local insurance regulations and CMS guidelines is essential to optimize reimbursement success.
Expertise in utilization review, mastery in crafting precise clinical denial appeal letters, and an in-depth knowledge of severity of illness and risk of mortality metrics are vital. Strong analytical abilities combined with nursing experience help navigate complex insurance denials effectively.
Professionals often progress into managerial roles such as RN Clinical Manager or Clinical Appeals Supervisor, or pivot towards healthcare compliance and revenue integrity leadership, leveraging their deep expertise in claims resolution and payer negotiations.
Catholic Health Initiatives fosters a collaborative environment emphasizing humankindness, offering resources and leadership that prioritize growth. This culture encourages skill development in clinical appeals and provides opportunities to influence financial outcomes positively.
Yes, the organization’s commitment to a mission-driven culture means appeals specialists often engage in multidisciplinary collaborations and dynamic adaptation to payer policies, which may differ from more transactional approaches at other institutions.
Salaries typically range between $75,000 and $95,000 annually, reflecting the specialized nursing skills and clinical appeals expertise required in this region. Remote roles often include benefits that complement the compensation package for these licensed RNs.
Centennial exhibits steady demand due to a robust healthcare sector, but Utah and Kansas also offer competitive opportunities thanks to expanding medical facilities. However, Colorado's focus on regulatory compliance and payer complexity elevates the need for skilled specialists locally.
A current Colorado RN license is mandatory, while additional certifications in utilization review or medical coding can enhance prospects. Familiarity with CMS regulations and payer-specific guidelines further boosts a candidate's attractiveness in this market.
Competition is moderate but growing, given the evolving healthcare reimbursement landscape. Highlighting extensive clinical experience, a strong track record in denial appeals, and proficiency in medical record coordination can differentiate candidates effectively.
This position uniquely combines clinical nursing expertise with detailed investigation of denied claims, requiring collaboration across departments and payers. Unlike bedside nursing, it focuses on documentation improvement, retrospective reviews, and payer negotiations to maximize revenue recovery.