A company is looking for a Clinical Appeals RN - Remote.
Key Responsibilities :
Perform medical reviews on provider inquiries and member appeals
Adhere to Department of Labor and State guidelines while maintaining confidentiality
Review and interpret plan language and document determinations accurately
Required Qualifications :
Active, unrestricted RN licensure in the state of residence
5+ years of RN experience in an acute care inpatient facility
Proven intermediate Microsoft skills (MS Word and Outlook)
Designated quiet workspace in the home and access to secure high-speed internet
Ability to work independently with solid self-discipline and time management skills
Licensed Clinical • Springfield, Massachusetts, United States