Job Summary
A healthcare company has a current position open for a Telecommute RC Appellate Clinician.
Individual must be able to fulfill the following responsibilities:
- Performing retrospective medical necessity reviews
- Constructing and documenting a succinct and fact based clinical case to support appeal
- Serving as a resource to non-clinical personnel
Skills and Requirements Include:
- Ability to travel approximately 10% of the time
- Current, valid RN/LPN/LVN licensure
- Must possess a valid nursing license
- 5 years recent acute care experience with the last 2 years in a facility environment
- 2 years UR/Case Management experience within the last 2 years
- Managed care payor experience a plus either in Utilization Review, Case Management or Appeals
