Job Summary
A healthcare business and operations provider has an open position for a Telecommute Clinical Appeals Nurse in Atlanta.
Candidates will be responsible for the following:
- Composing clinical appeal letters to send to payers
- Presenting a concise medical summary within each appeal
- Determining root cause of each denial
Must meet the following requirements for consideration:
- 1 year case management experience or relevant education
- State RN or LPN License
- Demonstrate understanding of use of all Medical Necessity software
- Demonstrate ability to interpret medical payer policy requirements
- Strong ability to research evidence-based practices
