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Nurse Reviewer Appeals And Hearings - Work from Home
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Work from home
- Summary We are seeking a talented individual for a Nurse Reviewer Appeals and Hearing to coordinate and perform all appeal-related duties including analyzing and responding appropriately to appeals from providers; reviewing documentation to ensure all aspects of the appeal have been addressed properly and accurately; preparing case files and case summaries for hearings; and participate in virtual and on-site hearings.
- Your role in our mission Reviews provider appeals and redeterminations using approved clinical and coding guidelines and documents appeal determinations clearly and concisely.
- What we're looking for Unrestricted RN license or Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Medical Auditor (CPMA) preferred.
- Working knowledge of the appeals and hearings process and experience using MCG or InterQual criteria preferred.
- What you should expect in this role Remote (Work from Home) Up to 25% Travel for onsite hearing testimony In order to effectively work as a teleworker with Gainwell, employees Broadband Internet connections, should have a minimum speed of 24MBS download and 8 MBS upload.
Expired 15 days agoInactive Job
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