Remote Appeals Nurse (RN)

Job Summary

A company is looking for a Remote Appeals Nurse.

Key Responsibilities

• Conduct first-level appeal reviews to assess medical necessity and compliance with Medicare guidelines
• Use clinical knowledge to evaluate claim documentation and write concise explanations for decisions
• Collaborate with team members to ensure accurate appeal decisions and participate in quality improvement initiatives

Minimum Qualifications

• Associate's (ASN) or Bachelor's (BSN) Degree in Nursing
• Active, unrestricted RN license in your state of residence/practice
• U.S. residency for at least 3 of the last 5 years
• Willingness to undergo and pass federal background screenings