RN Appeals Nurse Consultant

Job Summary

A company is looking for an Appeals Nurse Consultant - Work From Home.

Key Responsibilities

• Process medical necessity of Medicare Part C appeals from members and providers
• Request clinical information and apply appropriate Medicare guidelines
• Work independently and as part of a team in a fast-paced remote environment

Required Qualifications

• Active and unrestricted RN licensure in state of residence
• Associate's Degree in Nursing
• Appeals experience and/or utilization review preferred
• Medicare experience preferred
• Bachelor's Degree preferred