LPN or RN required; experience in clinical practice and appeals & grievances, claims processing, utilization review preferred. Knowledge of Utilization Review guidelines, InterQual or Medicare guidance; proficiency with Microsoft Word and Excel.
Key Responsibilities
- processing appeals
- classifying grievances
- entering data
Skills & Tools
Microsoft Word, Microsoft Excel, Macess, InterQual
Job Details
- Category: Healthcare Services - Nursing
- Seniority: Mid Level
- Commitment: Full Time
- Workplace: Remote — New York or West Virginia or North Dakota or Wisconsin or Indiana or Virginia or Texas or Tennessee or South Carolina or Pennsylvania or Ohio or Nevada or New Jersey or North Carolina or Minnesota or Maryland or Massachusetts or Florida or Delaware or Connecticut or New Hampshire or Arizona or Vermont or Alabama or Maine or Wyoming or Montana or South Dakota or Nebraska or New Mexico or Washington or Michigan or Hawaii or Oklahoma
- Salary: USD 73,400 – 120,360 / year
- Languages: English
Benefits
- Retirement plan
About Healthfirst
A not-for-profit health insurer focused on value-based care and improving member health through collaborative community and provider partnerships. — Industry: Healthcare