Arkansas Licensed Clinical Appeals Coordinator

Job Summary

A company is looking for a Clinical Appeals Coordinator.

Key Responsibilities

• Act as the liaison for statewide appeals and ensure compliance with State and NCQA requirements
• Review clinical information and prepare response letters for member and provider clinical appeals
• Maintain files and logs for all appeals and coordinate Fair Hearings with internal departments

Required Qualifications, Training, and Education

• Active RN license in Arkansas or current multistate/compact nursing license
• RN with 4+ years of clinical nursing and/or case management experience or LPN/LVN with 5+ years of experience
• Managed care or utilization review experience preferred
• LPN, LVN, or RN license required