Indiana Licensed Registered Nurse

Job Summary

A company is looking for a Registered Nurse, Appeals - Remote.

Key Responsibilities

• Draft and submit appeals for specialty patients with acute and chronic disease states
• Communicate with providers, patients, and pharmacy staff to obtain necessary clinical documentation and facilitate the appeals process
• Access multiple resources to check prior authorization, insurance, and appeal status while utilizing internal processing systems for record keeping

Required Qualifications

• Active, Registered Nurse License
• 2+ years of clinical experience as a Registered Nurse
• 1+ years of experience in prior authorization, pre-certification, utilization review, and/or appeals
• Understanding of clinical documentation from physician offices
• Proficiency with MS Word, Excel, and Point