Job Summary
A healthcare company is searching for a person to fill their position for a Telecommute Clinical Appeals Nurse in Largo.
Individual must be able to fulfill the following responsibilities:
- Present a concise medical summary within each appeal
- Contact appropriate parties as needed for additional information
- Determine root cause of each denial and apply company-specific coding
Must meet the following requirements for consideration:
- Demonstrate understanding of use of all Medical Necessity software
- Demonstrate ability to interpret medical payer policy requirements
- Strong ability to research evidence-based practices
- Communicates clearly and concisely, verbally and in writing
- At least one year case management experience required
- Professional presentation skills needed to represent facilities in legal issues
