West Virginia Licensed Appeals Nurse
VirtualVocationsEscondido, California, United Statesjob_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Clinical Appeals Coordinator, RN.
Key Responsibilities
Conducts and leads investigations and reviews for member and provider medical necessity appeals
Reviews medical records of denied services and ensures compliance with appeal timeframes
Documents case information and generates written responses to members or providers
Required Qualifications
Bachelor of Science in Nursing from an accredited program with an active nursing license
Five years of clinical experience, including two years in case management or utilization review
Medical management experience is preferred
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Nurse West Virginia • Escondido, California, United States
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