Job Summary
A healthcare company has a current position open for a Telecommute Clinical Appeals Nurse in Houston.
Candidates will be responsible for the following:
- Determining root cause of each denial and apply company-specific coding for trending and analysis
- Demonstrating understanding of use of all Medical Necessity software
- Composing clinical appeal letters
Qualifications for this position include:
- Demonstrates proficiency in Microsoft Office applications and others as required
- Able to work effectively with other employees, patients and external parties
- State RN or LPN License required
- Demonstrates knowledge and understanding of organizational policies, procedures and systems
- Able to perform basic mathematical calculations, balance and reconcile figures
- Professional presentation skills needed to represent facilities in legal issues
