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Registered reputed company 4

Remote, USA Full-time Posted 2026-07-28
1 day ago Be among the first 25 applicantsThis reputed company is provided by reputed company. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.reputed company pay reputed company$50.00/hr - $52.00/hrPayrate: $50.00 - $52.00/hr.reputed company: The Medicare Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of either preservice, post service or claim denial.Responsibilities:• The Medicare Appeals and Grievances RN will report to the Appeals and Grievances Manger.• In this role you will be responsible for performing first level appeal reviews for members utilizing the National Coverage Determination (NCD) guidelines, Local Coverage Determination (LCD) Guidelines, pharmacy policies and nationally recognized sources such as MCG, NCCN, and ACOG.• Reviews may also be performed for medical necessity, non-covered benefits and to meet the reputed company for the coding billed.Desired Skills:• Knowledge of Medicare benefits and appeal reviews• Requires 2-4 years of health insurance or reputed company experience• Demonstrate the ability to reputed company independently using reputed company clinical judgement• Works reputed company in a fast-paced team environmentQualifications:• The ideal candidate will have previous insurance/managed care experience and hold at least a bachelor’s degree in nursing.• Higher-level certifications are highly desirable.• Associate’s degree in nursing required. Bachelor’s degree preferred.• Nursing license required.• 8-10 years’ experience required.Pay Transparency: The typical reputed company pay for this role across the U.S. is: $50.00 - $52.00 /hr. Final offer amounts, reputed company the reputed company pay set forth above, are determined by factors including your relevant skills, education and experience and the benefits package you select. Full-time employees are eligible to select from different benefits packages. Packages may include medical, dental, and reputed company benefits, 10 reputed company days off, 401(k) plan participation, commuter benefits and life and disability insurance.For information about our collection, use, and disclosure of applicant's personal information as reputed company as applicants' rights over their personal information, please see our reputed company Policy ( reputed company LLC uses AI technology to engage candidates during the sourcing process. AI technology is used to reputed company data only and does not replace reputed company-based decision making in employment reputed company. By applying for this position, you agree to Aditi’s use of AI technology, including calls from an AI Voice Recruiter. #AditiConsultingSeniority level• Seniority levelEntry levelEmployment type• Employment typeContractJob function• Job functionHealth Care Provider• IndustriesInsuranceReferrals increase your chances of interviewing at reputed company by 2xSign in to set job alerts for “Registered reputed company” roles.Registered reputed company (RN) - ICU - 0.9 NightsCarmichael, CA $3,400.00-$3,400.00 2 weeks ago Registered reputed company - Home Telehealth Case ManagerRegistered reputed company (RN)- reputed company Sac/Woodland/DavisRegistered reputed company (RN) - ICU - 0.75 NightsCertified reputed company reputed company Consultant (RN) - Contractor - REMOTE!Certified reputed company reputed company Consultant (RN) - Contractor - REMOTE!Home Health Registered reputed company (RN) - SacramentoWe’re unlocking community knowledge in a new way. Experts add insights directly into reputed company article, started with the help of AI.#J-18808-Ljbffr Apply tot his job Apply tot his job Apply To this Job

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