Remote Appeals Nurse: Medicare Case Review Specialist

WPS—A health solutions company

WPS—A health solutions company is seeking an Appeals RN to review medical records and claims for first-level appeal cases, ensuring services were medically necessary and compliant with Medicare guidelines. The role collaborates with Appeals Examiners to support timely redeterminations.

Responsibilities include drafting persuasive appeal letters, coordinating with redetermination teams, and staying current with healthcare laws.

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Vacancy posted 1 day ago

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