Appeals Nurse Consultant (Remote)
About the position Responsibilities • Process medical necessity of Medicare appeals for participating providers • Request clinical information and conduct research • Extrapolate pertinent clinical data • Apply appropriate Medicare guidelines • Navigate through multiple computer system applications • Work independently and in a team environment • Communicate effectively via telephone and computer Requirements • 3+ years of clinical experience required • Active and unrestricted RN licensure in state of residence Nice-to-haves • Coding experience • Managed Care experience • Utilization Management experience • Appeals experience • Pre Certification experience • Pre Authorization experience Benefits • Full range of medical, dental, and vision benefits • 401(k) retirement savings plan • Employee Stock Purchase Plan • Fully-paid term life insurance • Short-term and long-term disability benefits • Well-being programs • Education assistance • Free development courses • CVS store discount • Discount programs with participating partners • Paid Time Off (PTO) • Paid holidays throughout the calendar year Apply tot his job