RN APPEALS WRITER SKILLS CHECKLIST

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RN APPEALS WRITER SKILLS CHECKLIST

Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

KNOWLEDGE, SKILLS, ABILITIES

No Experience Need Traning Able to perform with Supervision Able to perform Independetly
Review, analysis and extraction of clinical information from patient records
Drafting of effective narratives for Medicare and Medicaid appeals documentation
Drafted briefs in support of denied cases under appeal at all levels of the government appeals process
Maintained current knowledge base of medical coding
Knowledge of federal and state hopsital Utilization Review (UR) regulations
Knowledge of of Medicare guidelines regarding medical necessity
Knowledge of of Medicare guidelines regarding inpatient and outpatient observation
Research and preparation for beneficiary hearings
Experience testifying as expert witness in hearings
Collaborated with internal and external legal sources
Chart review skills
Ability to quickly research and extract relevant data from a medical record
Develop and Draft clear narratives for a solid case in support of medical claims for appeals
Experience with electronic medical record
Knowledge and experience with acute hospital utilization review using InterQual and/or Milliman
Working knowledge of medical coding
Knowledge and experience with case management
Knowledge and experience with government and contacted payers
Attention to details, timeliness and accuracy
Ability to work independently while working efficiently
Ability to work comfortably within a high production team
Age Specific Competencies

No Experience Need Traning Able to perform with Supervision Able to perform Independetly
Infant (Birth – 1 year)
Preschooler (ages 2-5 years)
Childhood (ages 6-12 years)
Adolescents (ages 13-21 years)
Young Adults (ages 22-39 years)
Adults (ages 40-64 years)
Older Adults (ages 65-79 years)
Elderly (ages 80+ years)

I hereby certify that ALL information I have provided on this skills checklist, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.