Job Summary
A healthcare company is filling a position for a Remote Grievances and Appeals Registered Nurse.
Core Responsibilities Include:
- Acting as a member advocate addressing member or provider concerns
- Analyzing, reviewing and evaluating appeals and grievances
- Researching, investigating and summarizing complex issues
Qualifications for this position include:
- Quarterly travel for team events and trainings
- Active, unrestricted Registered Nurse license
- Minimum of 2 years of appeals experience in a payer-based environment
- Minimum of 5 years of acute care or outpatient clinical experience
- Minimum of 3 years of utilization management experience in a payer-based environment
- Excellent written and oral communication skills