Job Summary
A healthcare business and operations provider is searching for a person to fill their position for a Telecommute Clinical Appeals Nurse in Nashville.
Candidates will be responsible for the following:
- Composing clinical appeal letters to send to payers for denial reconsiderations
- Presenting a concise medical summary within each appeal
- Contacting appropriate parties (internal and/or external) as needed for additional information
Must meet the following requirements for consideration:
- At least one year case management experience
- State RN or LPN License required
- Demonstrate understanding of use of all Medical Necessity software
- Demonstrate ability to interpret medical payer policy requirements