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RN Appeals Nurse Consultant

7/8/2025

Not specified

Job Summary

A company is looking for an Appeals Nurse Consultant - Fully Remote.

Key Responsibilities
  • Process medical necessity appeals for Medicare Part C from members and providers
  • Collaborate with internal and external partners to gather necessary information and provide written recommendations
  • Review and prepare appeals for MD review while ensuring adherence to guidelines


Required Qualifications
  • Active and unrestricted RN licensure in state of residence
  • 3+ years of clinical experience
  • Associate's degree or RN diploma required

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