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Appeals Nurse Consultant (Remote)

Posted 12 days agoViewed

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💎 Seniority level: Middle, 3+ years of clinical experience required

📍 Location: United States of America

💸 Salary: 66575.0 - 142576.0 USD per year

🔍 Industry: Healthcare

🗣️ Languages: English

⏳ Experience: 3+ years of clinical experience required

Requirements:
  • 3+ years of clinical experience required.
  • Active and unrestricted RN licensure in the state of residence is needed.
  • Preferred qualifications include coding experience, managed care experience, utilization management experience, appeals experience, pre-certification experience, and pre-authorization experience.
  • An Associate's Degree or Diploma in RN is required; a Bachelor's Degree is preferred.
Responsibilities:
  • The Appeals Nurse Consultant processes the medical necessity of Medicare appeals for providers.
  • Primary duties include requesting clinical data and research.
  • Extrapolating pertinent clinical information and applying appropriate Medicare Guidelines is required.
  • Must navigate multiple computer systems in a fast-paced department.
  • Independent and team work is expected while working remotely.
  • Position involves talking on the phone, looking at computer screens, and typing.
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