RN Appeal Analyst - NJ Licensed
Company: VirtualVocations
Location: Sunnyvale
Posted on: November 7, 2024
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Job Description:
A company is looking for an Appeal Analyst RN to review Level 2
Commercial Appeals.
Key Responsibilities
Review and investigate reasons for UM denials and appeal
requests
Present clinical information to a committee effectively
Maintain turnaround time by making sound clinical judgments
quickly
Required Qualifications
Active Unrestricted RN License in NJ or Compact
Experience with health plan appeals is essential
Proficient in navigating UM policies and clinical guidelines
Knowledge of UM Pharmacy appeals is preferred
Technology savvy with experience in Care Radius, Outlook, Teams,
and Microsoft Suite
Keywords: VirtualVocations, Rancho Cordova , RN Appeal Analyst - NJ Licensed, Healthcare , Sunnyvale, California
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