Wisconsin Licensed Clinical Appeals RN

Job Summary

A company is looking for a Clinical Appeals RN - Remote.

Key Responsibilities:

• Perform medical reviews on provider inquiries and member appeals
• Adhere to Department of Labor and State guidelines while maintaining confidentiality
• Review and interpret plan language and document determinations accurately

Required Qualifications:

• Active, unrestricted RN licensure in the state of residence
• 5+ years of RN experience in an acute care inpatient facility
• Intermediate Microsoft skills (MS Word and Outlook)
• Ability to work independently with a designated quiet workspace
• Access to secure high-speed internet in the home