RN Appeals Nurse Consultant

Job Summary

A company is looking for an Appeals Nurse Consultant (Remote).

Key Responsibilities

• Process medical necessity of Medicare appeals for participating providers
• Review documentation and interpret data from clinical records to apply clinical criteria and policies
• Work independently and collaboratively in a fast-paced remote environment

Required Qualifications

• Active and unrestricted RN licensure in state of residence
• 3+ years of clinical experience
• Associates Degree or Diploma RN required; Bachelor's Degree preferred