Job Summary
A healthcare company needs applicants for an opening for a Remote Clinical Appeals Registered Nurse.
Candidates will be responsible for the following:
- Analyzing and reviewing appeals/grievances
- Being a clinical problem solver with facilities and providers, and resolving issues concerning members
- Monitoring and analyzing medical management activities
Qualifications for this position include:
- A current, valid and unrestricted RN licensure in your state of residence
- 5+ years clinical experience in an acute care or an outpatient setting
- 1+ years of utilization review, case management or medical appeal review experience
- Strong Microsoft Office (Word, Excel & Outlook)
- Must have access to high speed internet