Job Summary
A healthcare company has an open position for a Remote Clinical Appeals Registered Nurse.
Individual must be able to fulfill the following responsibilities:
- Review provider post-service appeals for Medicare and Retirement
- Gather clinical information including medical records and coverage criteria
- Discuss cases with medical directors when applicable
Must meet the following requirements for consideration:
- Attend mandatory trainings and scheduled staff meetings
- Active, Unrestricted RN license
- 2+ years of RN experience in acute setting
- Working knowledge of MCG and CMS guidelines
- Proficient in Basic Computer Skills
- Must meet all other listed company requirements