Utah Licensed Clinical Appeals Consultant

Job Summary

A company is looking for a Clinical Appeals Consultant PRN.

Key Responsibilities

• Review medical records and perform clinical assessments for patient accounts to support appeals
• Collaborate with multidisciplinary teams to prepare and submit clinical appeals
• Attend and testify at hearings regarding the medical necessity of admissions

Required Qualifications, Training, and Education

• Graduate of an accredited school of nursing (Associates or Bachelor's degree)
• Current valid RN License
• Three years of experience in utilization review or care management in a healthcare setting
• Preferred: Bachelor's degree (BSN)
• Preferred: Five years of experience in the relevant fields