Job Summary
A staffing agency is in need of a Telecommute Clinical Appeals Manager.
Core Responsibilities Include:
- Reviewing clinical appeal letters
- Ensuring employee compliance with HIPAA regulations
- Assisting with reviewing appeal letters as necessary
Qualifications for this position include:
- Ability to attend client meetings as needed and/or required
- Registered Nurse
- Knowledge and experience with national clinical criteria applied in case management
- Working knowledge of billing codes, Revenue Codes, and CPT
- Experience and knowledge of managed care contracts
- Other requirements as outlined in the job description
