Remote PRN Appeals Nurse

Job is Expired

Location: Nationwide

Compensation: To Be Discussed

Staff Reviewed: Mon, Oct 25, 2021

Job Category: Healthcare

Remote Level: 100% Remote

Weekly Hours: Part Time

Employer Type: Employer

Career Level: Experienced

Education Level: Bachelors

Job Summary

A software development company is seeking a Remote PRN Appeals Nurse .

Core Responsibilities Include:

  • Prepare professional, effective clinical appeals in response to managed care, governmental, or RAC denials for hospital clients
  • Utilize various guidelines in reviewing medical records and writing appeals
  • Participate in telephonic Administrative Law Judge Hearings and present oral arguments for reversing Medicare denials

Qualifications for this position include:

  • Bachelor of Science degree in Nursing
  • At least 3 years of case management, concurrent review or utilization management experience
  • At least 5 years of clinical experience in acute care setting
  • Current state RN licensure
  • Proficiency in medical record review

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