Hospital Appeals Specialist (RN), Full Time, Day (8a-4p), Morristown, NJ

This position reports to the Manager of Denials. The position will be responsible for completing clinical review of denied services, preparing clinical discussion and appeal letters to be sent to the payers.

The Denial Management Nurse is considered a clinical expert in denial management and avoidance and ensures all denied claims are accurately worked from a clinical perspective and appropriately appealed to secure maximum reimbursement and minimize organizational write-offs.

Will collaborate closely with leadership and staff within and outside of the revenue cycle team for the purpose of improving clinical, operational, and financial outcomes.

Job Detail:

• Develop the denials department and create workflows for in-house submission of denials. Ultimately, developing an in-house appeals department.

• Determine root cause of denials

• Establish and manage relationships with AHS leaders, facilitate regular meetings to present, and review denials information

• Effectively manage the department’s workflow processes, follow productivity and quality standards, and ensure denied claims are submitted and followed up in a timely manner

• Understand explanation of benefits from payors in all areas of non-governmental insurance claims.

• Analyze hospital claims data to identify contractual underpayments, denials, and billing errors.

• Make billing adjustments in system based on outcome of denial.

• Submit information to payors as necessary and follow up with payors on in-house submitted denials.

• Manage assigned work queues (Revenue integrity and denials)

• Working with the department staff provide monthly denial reports to department manager, clinical departments, and case management.

• Able to work independently

Education & Licensure

• Active NJ Registered Nurse (RN) license

• Bachelor of Science in Nursing (BSN) preferred

• 3 - 5+ years of clinical experience (acute care preferred)

Experience in:

• Utilization Review

• Case Management

• Clinical Documentation Improvement

• Medical Record Audits

• Denials/Appeals or Revenue Cycle

At Atlantic Health, our promise to our communities is; Anyone who enters one of our facilities will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 22,000 team members. Headquarters in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:

• Atlantic Health Morristown Medical Center, Morristown, NJ

• Atlantic Health Overlook Medical Center, Summit, NJ

• Atlantic Health Newton Medical Center, Newton, NJ

• Atlantic Health Chilton Medical Center, Pompton Plains, NJ

• Atlantic Health Hackettstown Medical Center, Hackettstown, NJ

• Atlantic Health Goryeb Children's Hospital, Morristown, NJ

• Atlantic Health CentraState Healthcare System, Freehold, NJ

• Atlantic Medical Group

• Atlantic Visiting Nurse

• Atlantic Mobile Health

• Atlantic Rehabilitation

We have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group.

We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades:

• Chosen for 17 years by Fortune as one of the magazine’s “100 Best Companies to Work For."

• Atlantic Health Morristown and Atlantic Health Overlook Named by Newsweek as two of the “World’s Best Hospitals” in 2026.

• Atlantic Health Morristown and Atlantic Health Overlook ranked within the top three hospitals in New Jersey by U.S. News & World Report’s 2025-2026 Best Hospital rankings.

• Atlantic Health scored four “A” grades by The Leapfrog Group in its Fall 2025 Hospital Safety Grades, performance measures reflecting errors, accidents, injuries and injections, as well as systems hospitals have in place to prevent harm.

• Atlantic Health Morristown and Atlantic Health Overlook are New Jersey's only hospitals to be named among America's 50 Best hospitals by Healthgrades in 2026.

• Named by Becker's Healthcare as one of the "165 Top Places to Work in Healthcare – 2026.

• Atlantic Health Morristown, Atlantic Health Overlook, Atlantic Health Chilton and Atlantic Health Newton all Forbes Top Hospitals for 2026.

• Named by Newsweek as one of America’s Greatest Workplaces for Inclusion & Diversity 2025.

• Atlantic Health rated LEVEL 9 - 2025 CHIME Digital Health Most Wired.

Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted:

Team Member Benefits

• Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)

• Life & AD&D Insurance.

• Short-Term and Long-Term Disability (with options to supplement)

• 403(b) Retirement Plan: Employer match, additional non-elective contribution

• PTO & Paid Sick Leave

• Tuition Assistance, Advancement & Academic Advising

• Parental, Adoption, Surrogacy Leave

• Backup and On-Site Childcare

• Well-Being Rewards

• Employee Assistance Program (EAP)

• Fertility Benefits, Healthy Pregnancy Program

• Flexible Spending & Commuter Accounts

• Pet, Home & Auto, Identity Theft and Legal Insurance

Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.

EEO STATEMENT

Atlantic Health, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran