California Licensed Clinical Appeals RN
VirtualVocationsOrange, California, United Statesjob_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
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job_description.job_card.job_description
A company is looking for a Clinical Appeals RN, fully remote, requiring 4 or 5 workdays per week with weekends required.
Key Responsibilities
Review medical records and verify if requested services meet criteria
Analyze and evaluate pre-service appeals for clinical eligibility for coverage
Document determinations accurately and coordinate reviews with the Medical Director
Required Qualifications
Active, unrestricted RN license in state of residence
2+ years of clinical experience as an RN, including in an acute, inpatient hospital setting
Proficiency in Microsoft Office applications
Availability for 5-day work weeks, including weekends
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Clinical California • Orange, California, United States
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