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Remote Appeals Nurse for Medicare Medical Review

WPS Health Solutions

WPS Health Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims for first-level appeals to determine medical necessity and coverage alignment.

The role collaborates with Appeals Examiners to prepare timely redeterminations, document clinical rationales, and ensure compliance with CMS guidelines. A registered nurse with strong communication and attention to detail is essential for success in this fast-paced environment.

#J-18808-Ljbffr
Vacancy posted 7 hours ago
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