RN Appeals Writer Skills Checklist

Fill Out and Submit your Skills Checklist

(Rn Appeals Writer)

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Last 4 Of SSN

Date

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

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.

Proficiency Scale:

1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently

Knowledge, Skills, Abilities

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 hospital Utilization Review ("UR") regulations:

★★★★

Knowledge of Medicare guidelines regarding medical necessity:

★★★★

Knowledge 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 contracted 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

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):

★★★★