Telecommute Healthcare Appeals Specialist

Job ID: Available for Members

Location: Nationwide

Compensation: To Be Discussed

Posted: Friday, August 10, 2018

Job Category: Healthcare, Nursing, Project Management

Telecommute Level: 100% Telecommute

Travel Requirements: No Travel

Weekly Hours: Day Shift, Full Time

Employer Type: Employer

Career Level: Experienced

Education Level: Some College

Job Summary

An insurance company is searching for a person to fill their position for a Telecommute Appeals Specialist.

Core Responsibilities of this position include:

  • Managing a team to meet all applicable performance and quality requirements
  • Ensuring all cases submitted to the IRE include all required information and details necessary to support the uphold decision
  • Ensuring consistency in decision making through inter rater reliability

Position Requirements Include:

  • Proven ability to analyze clinical fact patterns, compare and contrast decisions, and utilize results
  • Licensed Registered Nurse or Registered Nurse
  • 4 years' experience with Medicare Part C
  • 2-4 years of prior leadership/coaching and training experience