Nurse - Appeals

Posted about 21 hours agoViewed

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💎 Seniority level: Senior, 5 years

📍 Location: United States, EST, NOT STATED

💸 Salary: 26.01 - 56.14 USD per hour

🔍 Industry: Healthcare

🗣️ Languages: English

⏳ Experience: 5 years

🪄 Skills: Data AnalysisCommunication Skills

Requirements:

Registered Nurse (RN) certification
5 years work experience
Working knowledge of medical terminology
Digital literacy skills
Problem solving and decision making skills

Responsibilities:

Examine denied or rejected healthcare insurance claims
Communicate with providers to gather supporting documentation
Conduct research on medical guidelines and insurance policies
Develop complex utilization reviews for appeals
Edit or draft appeal letters
Examine medical records for medical necessity criteria
Guide and support patients throughout the appeals process
Implement an appeal framework for nurses