✨ About The Role
- The Appeals Nurse Consultant will be responsible for processing Medicare appeals related to medical necessity for participating providers.
- Key responsibilities include requesting clinical information, conducting research, and applying appropriate Medicare guidelines.
- The position requires navigating multiple computer systems in a fast-paced environment.
- The role is primarily sedentary, involving extensive use of a computer and telephone.
- Standard business hours are Monday to Friday, from 8 AM to 5 PM in the employee's time zone.
âš¡ Requirements
- The ideal candidate will have at least 3 years of clinical experience, demonstrating a strong background in nursing.
- An active and unrestricted RN licensure in the state of residence is essential for this role.
- Experience in coding, managed care, and utilization management will be highly beneficial.
- The successful applicant should be comfortable working independently as well as collaboratively in a remote team environment.
- Strong communication skills are necessary, as the role involves talking on the telephone and interacting with various stakeholders.