Appeals Nurse (LPN or RN)

Job Description

Job Description

A-Line staffing is hiring an Appeals Nurse (LPN or RN) in West Des Moines Iowa!!

If interested APPLY NOW to Chris Meyer for IMMEDIATE consideration!!

Appeals Nurse Details:

• Location: Remote work with potential to move onsite to West Des Moines, IA after about 6 months – must live in Iowa and have an active Iowa Nursing License
• Schedule: Monday-Friday 8:00am-5:00pm

Appeals Nurse Compensation

• The pay for this position can vary from $30-$50 per hour depending on years of experience and licensure
• Benefits are available to full-time employees after 90 days of employment
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Appeals Nurse Qualifications :

• Active LPN or RN license in the state of Iowa
• Must reside in Iowa (Able to commute to West Des Moines if needed)
• 3+ years of nursing experience Required
• 2+ years of Experience with Utilization Review, Appeals, Denials, or authorizations highly preferred
• Must have solid computer skills

Appeals Nurse Responsibilities :

• Review and process Iowa Medicaid Member Appeals
• Member appeal requests are received and assigned by the team lead, the appeals nurse is responsible for working the appeal start to finish.
• Outreach attempts are made to member/provider.
• A clinical review is completed and case sent to specialty review/MD.
• Appeals nurse will write determination letters and close the case.
• 30 calendar days to complete standard cases and 3 business days to acknowledge receipt of the case.
• This team handles all Iowa Medicaid appeals except behavioral health

Appeals Nurse Preferred Qualifications :

• Writing Appeal/Authorization outcome letters
• Previous managed care or MCO experience is highly preferred

If interested APPLY NOW to Chris Meyer for IMMEDIATE consideration!!