Remote Appeals Nurse - Medicare Case Review Expert

WPS—A health solutions company

WPS—A health solutions company is seeking an Appeals Nurse (RN) to review medical records and claims for first-level appeal cases to determine medical necessity under Medicare guidelines. The role collaborates with Appeals Examiners to ensure timely redeterminations.

In Illinois and other approved states, you will prepare appeal letters, support clinical evidence, and stay current with healthcare regulations. A BSN/ASN and active RN license are required, with 1+ year of clinical experience.

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Vacancy posted 5 days ago

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