Job Summary
A healthcare staffing and recruiting firm has a current position open for a Remote Appeals and Grievance Registered Nurse.
Individual must be able to fulfill the following responsibilities:
- Maintain strict compliance with federal, state and NCQA requirements and guidelines
- Manage the consolidation of the complaints and grievance activities
Position Requirements Include:
- Requires 1-2 years previous experience in Denials, Appeals, Grievances, Complaints at a managed care organization
- Around 3-5 years of acute care clinical nursing experience
- Requires a valid, unrestricted state license as a Registered Nurse (RN)
- Experience using standardized clinical guidelines
