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Remote Health Insurance Appeals Registered Nurse

Company: VirtualVocations
Location: Grand Prairie
Posted on: January 16, 2023

Job Description:

A non-profit health insurance company is searching for a person to fill their position for a Remote Health Insurance Appeals Registered Nurse.

Individual must be able to fulfill the following responsibilities:
Utilize clinical knowledge and clinical review judgment to conduct medical review of claim documentation for first-level appeal cases
Provide clear and concise written explanations for reason a specific claim or set of claims
Analyze referrals and identify specific high-volume problem issues and relay information to Redeterminations Manager and Senior Analyst
Qualifications for this position include:

Active RN license, applicable to state of practice
Bachelor's Degree in related field or
Equivalent post high school and/or related work experience
Ability to utilize clinical knowledge and clinical review judgment to conduct medical review of claim documentation
Ability to analyze referrals and identify specific high-volume problem issues and relay information

Keywords: VirtualVocations, Grand Prairie , Remote Health Insurance Appeals Registered Nurse, Other , Grand Prairie, Texas

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