Telecommute Clinical Appeals Nurse in Orange Park

Job ID: Available for Members

Location: Florida

Compensation: To Be Discussed

Staff Reviewed: Tue, Jun 19, 2018

Job Category: Case Management, Healthcare, Nursing

Telecommute Level: Majority

Travel Requirements: Possible Travel

Weekly Hours: Full Time

Employment Status: Permanent

Employer Type: Employer

Career Level: Entry Level

Education Level: Some College

Additional Information: Benefits Available

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