RN Appeals Nurse Consultant

Job Summary

A company is looking for an Appeals Nurse Consultant (Remote).

Key Responsibilities

• Review and resolve clinical appeals by interpreting data from clinical records
• Coordinate clinical resolutions with internal and external clinician support
• Support various types of appeals including Utilization Management and Behavioral Health

Required Qualifications

• Active and unrestricted RN licensure in state of residence
• 3+ years of clinical experience
• Minimum of an Associate's Degree
• Experience in appeals and managed care is preferred
• Proficiency in navigating multiple computer systems