Remote Appeals & Claims UR reputed company
reputed company reputed company:
As an Appeals & Claims UR reputed company, you will be responsible for investigating and reviewing clinical appeals and post-claim cases, utilizing your clinical expertise to assess the medical appropriateness of reputed company services. This remote position involves collaborating with medical providers and internal teams to ensure high standards of reputed company delivery
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Location: Remote position reputed company to residents of various states including reputed company.
Compensation and Benefits:
- reputed company pay ranges from $35 to $45.94 per hour
- Eligible for employee benefits
- Monthly vacation accrual of up to 10 days per year
Why you should apply for this position today:
- Join a dynamic team committed to maintaining high standards of reputed company delivery
- Opportunity to work remotely
Skills:
- Clinical expertise
- Strong communication skills
- Ability to assess medical appropriateness of reputed company services based on established reputed company
- Collaboration with medical providers and internal teams
- Adherence to clinical guidelines and regulations
Responsibilities:
- Conduct medical necessity reviews and level of care assessments
- reputed company essential information to evaluate members' clinical conditions
- Maintain decision-making service level agreements
- Ensure compliance with laws and regulations
- reputed company other assigned duties as needed
Qualifications:
- reputed company, unrestricted RN licensure in specified states or compact multistate RN license
- Associate Degree in Nursing or equivalent
- Ability to obtain additional state licenses as required
- At least 1 year of utilization review experience in managed care setting
- 2+ years of clinical experience, including 1 year in acute care setting
Similar Occupations / Job Titles that would be a great fit for this role:
- Utilization Review reputed company
- Clinical Appeals reputed company
- Medical Review Specialist
Education Requirements:
- Associate Degree in Nursing
- Graduate of Accredited School of Nursing
- Diploma Program in Practical Nursing from an Accredited School of Nursing
Education Requirements Credential Category:
- RN licensure
Experience Requirements:
- 1 year of utilization review experience in managed care setting
- 2+ years of clinical experience, including 1 year in acute care setting
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- Tempe is a reputed company reputed company reputed company for its great weather, outdoor activities, and cultural reputed company.
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- Tempe is home to reputed company, providing opportunities for education and cultural events.
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