Job Summary
A healthcare corporation is searching for a person to fill their position for a Telecommute Clinical Appeals Nurse in Orange Park.
Candidates will be responsible for the following:
- Composing clinical appeal letters to send to payers for denial reconsiderations
- Using Medical Necessity software, including but not limited to InterQual©
- Interpreting medical payer policy requirements
Skills and Requirements Include:
- Professional presentation skills needed to represent facilities in legal issues
- State RN or LPN License required (Active/Inactive)
- At least one year case management experience required
- Relevant education may substitute experience requirement
- Proficiency in Microsoft Office applications