A healthcare company is seeking a Remote Clinical Appeals Nurse in Orange Park. Core Responsibilities of this position include: Determining root cause of each denial and apply company-specific coding for trending and analysis. Presenting a concise medical summary within each appeal.
Approximately 50% travel will be required. At least two years prior oncology research experience is required. A strong health-care related background. Bachelor's degree from an accredited college or university or be a graduate of an accredited school of nursing. Oncology research experience.
Bachelor’s degree in Nursing or related field. Valid and current nursing license. Minimum 2 years HEDIS Hybrid experience. Minimum 5 years management experience. Previous experience in a managed care setting with previous experience in health care analysis.