The Manager of Clinician Appeals is a clinical leader responsible for the strategic oversight and operational execution of the appeals letter writing and client education engagement.
Lead high-performing clinical teams in the development of clinically accurate, persuasive, and compliant appeal communications to payers.
Ensure operational excellence, clinical integrity, and alignment with financial goals.
Work closely with internal leadership, administrative operations, and external clients to ensure best-in-class service delivery in a dynamic revenue cycle environment.
Analyze denial types, identify root causes, and deliver actionable feedback that helps prevent future denials.
Manage and develop both domestic and global clinicians who write appeal letters.
Oversee hiring, onboarding, training, and performance management of clinical writers.
Define and implement the team’s leadership structure and workflows.
Enforce quality and productivity standards; take corrective action as needed to maintain high performance.

RN, MD or DO license required; active, unrestricted medical license (any state) preferred
Minimum 8+ years of clinical experience with at least 5 years in a leadership role within appeals, utilization management, clinical documentation improvement (CDI), or similar RCM functions
Strong knowledge of payer appeals processes, healthcare regulations, and documentation standards
Demonstrated success in managing clinical teams in a high-volume, fast-paced environment
Proven experience developing QA programs and implementing clinical workflow improvements
Strong understanding of financial models and operational KPIs in the revenue cycle industry
Exceptional communication, collaboration, and leadership skills.

Manager, Clinician Appeals

Key skills