Indiana Licensed Appeals Registered Nurse

Job Summary

A company is looking for a Registered Nurse, Appeals Drafting Service - Remote.

Key Responsibilities

• Draft and submit appeals for specialty patients, including preparing appeal letters and obtaining necessary clinical documentation
• Facilitate the appeals process by communicating with providers, patients, and insurance companies to gather denial information
• Utilize multiple internal processing systems for record keeping and tracking of appeal determinations

Required Qualifications

• Active, Registered Nurse License
• Willingness to obtain Case Management Certification (CCM) once eligible
• 2+ years of clinical experience as a Registered Nurse
• 1+ years of experience with prior authorization, pre-certification, utilization review, and/or appeals
• Proficiency with MS Word, Excel, and Point