Job Summary
A healthcare company needs applicants for an opening for a Telecommute Appeals Nurse Consultant.
Candidates will be responsible for the following:
- Reviewing clinical appeals from participating inpatient and outpatient Medicare Advantage providers
- Making medical necessity recommendations based on industry standards
- Reviewing post service provider appeal requests
Qualifications for this position include:
- 0-10% Travel
- 3 years+ clinical experience required
- Associate's degree or equivalent experience
- Active unrestricted Nursing/Registered Nurse is required
- Nursing/medical-surgical care/1+ years experience
- Clinical/medical/concurrent review/discharge planning/1+ years experience