Job Summary
A healthcare business and operations provider has a current position open for a Remote Clinical Appeals Registered Nurse in Orange Park.
Core Responsibilities Include:
- Composing clinical appeal letters to send to payers for denial reconsiderations
- Presenting a concise medical summary within each appeal based on support from the medical record
- Demonstrating understanding of use of all Medical Necessity software
Qualifications for this position include:
- State RN or LPN License required (Active/Inactive)
- At least 1 year case management experience required
- OR relevant education may substitute experience requirement
- Able to handle appeals requiring clinical input or interpretation
