State Licensed Appeals Nurse
A company is looking for an Appeals Nurse to join their Specialty Appeals Team. Key Responsibilities Adhere to company policies and procedures in utilization and appeals management Document communications with medical staff and interface with other departments to resolve appeal-related issues Provide customer service and collaborate with Clinical Reviewers for timely adjudication of appeals Required Qualifications, Training, and Education 1-3 years of experience as a Registered Nurse (RN) - Required Minimum of 5 years in Utilization Management or healthcare appeals - Required Able to work in a rotation from 10:30am to 7pm CST and 8am - 5pm EST/CST - Required Preferred ability to exercise independent judgment in clinical decision-making Preferred experience with Microsoft Office and strong organizational skills
A company is looking for an Appeals Nurse to join their Specialty Appeals Team.
Key Responsibilities
Adhere to company policies and procedures in utilization and appeals management
Document communications with medical staff and interface with other departments to resolve appeal-related issues
Provide customer service and collaborate with Clinical Reviewers for timely adjudication of appeals
Required Qualifications, Training, and Education
1-3 years of experience as a Registered Nurse (RN) - Required
Minimum of 5 years in Utilization Management or healthcare appeals - Required
Able to work in a rotation from 10:30am to 7pm CST and 8am - 5pm EST/CST - Required
Preferred ability to exercise independent judgment in clinical decision-making
Preferred experience with Microsoft Office and strong organizational skills
