Remote Clinical Appeals Registered Nurse

Location: Arizona, Florida, Georgia, Idaho, Ohio, Oregon, Texas, Utah, Virginia

Compensation: Salary

Staff Reviewed: Wed, Nov 04, 2020

This job expires in 4 days

Job Category: Healthcare

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Staffing Agency

Career Level: Experienced

Job Summary

A staffing firm has an open position for a Remote Clinical Appeals Registered Nurse.

Core Responsibilities of this position include:

  • Reviewing member and provider appeals submitted from Customer and Provider Services
  • Creating episodes in UM system for management and documentation of the clinical review process
  • Reviewing correspondence and medical records autonomously using sound judgment and good decision making

Applicants must meet the following qualifications:

  • Valid Idaho Registered Nurse License
  • One-year of clinical appeals experience
  • One-year of utilization management / discharge planning