• Clinical Appeals Specialist

    TEKsystems (San Bernardino, CA)


    Clinical Appeals Nurse – Revenue Cycle Management

     

    We are looking for a Clinical Appeals Nurse to join our Revenue Cycle Management team. In this role, you will play a critical part in managing clinical denials related to medical necessity, level of care, DRG revisions, and delays in service for inpatient stays. Unlike short-stay cases (1–3 days), which are handled by a vendor, this position focuses on longer inpatient stays—ranging from 5 days to 100+ days—requiring detailed review and strategic appeal preparation.

    Key Responsibilities

    + Review medical records for inpatient cases to identify and address denial reasons.

    + Prepare comprehensive clinical documentation and narratives to support appeals.

    + Submit and track appeals through the designated work queue system.

    + Collaborate with a team of LVNs and RNs to ensure accuracy and completeness of appeal submissions.

    + Evaluate cases for medical necessity, level of care compliance, DRG revisions, and delay in service issues.

    + Partner with follow-up specialists to monitor appeal outcomes and maintain timely communication.

    What You’ll Bring

    + Strong clinical knowledge and ability to interpret complex medical records.

    + Experience in clinical appeals, utilization review, or revenue cycle management.

    + Excellent attention to detail and organizational skills for handling high-volume, long-stay cases.

    + Ability to work collaboratively with nursing teams and other stakeholders.

     

    Job Type & Location

     

    This is a Contract position based out of San Bernardino, CA.

    Pay and Benefits

    The pay range for this position is $26.00 - $30.00/hr.

     

    Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

     

    Workplace Type

     

    This is a fully onsite position in San Bernardino,CA.

     

    Application Deadline

     

    This position is anticipated to close on Dec 26, 2025.

    h4>About TEKsystems:

    We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

     

    The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

    About TEKsystems and TEKsystems Global Services

    We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

     

    The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.