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Ohio Licensed Clinical Appeals Nurse
A company is looking for a Clinical Appeals Nurse to manage clinical appeals and state hearings remotely. Key Responsibilities Complete clinical appeals and state hearings from all states within required timeframes Prepare State Hearing packets and communicate with state agencies and internal departments Maintain documentation accuracy and conduct appeals reporting Required Qualifications Bachelor's degree in Finance, Business, Economics, Engineering, or a valid RN License is required Associates Degree or equivalent relevant experience is required Managed care, appeals, and Medicaid experience preferred Utilization review experience is strongly preferred Current, unrestricted RN license and MCG Certification required within six months of hire
A company is looking for a Clinical Appeals Nurse to manage clinical appeals and state hearings remotely.
Key Responsibilities
Complete clinical appeals and state hearings from all states within required timeframes
Prepare State Hearing packets and communicate with state agencies and internal departments
Maintain documentation accuracy and conduct appeals reporting
Required Qualifications
Bachelor's degree in Finance, Business, Economics, Engineering, or a valid RN License is required
Associates Degree or equivalent relevant experience is required
Managed care, appeals, and Medicaid experience preferred
Utilization review experience is strongly preferred
Current, unrestricted RN license and MCG Certification required within six months of hire
