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Remote Appeals Nurse - Medicare Medical Necessity
Remote / Online - Candidates ideally in
Fond du Lac, Fond du Lac County, Wisconsin, 54935, USA
Listed on 2026-08-15
Fond du Lac, Fond du Lac County, Wisconsin, 54935, USA
Listing for:
WPS Health Solutions
Remote/Work from Home
position Listed on 2026-08-15
Job specializations:
-
Healthcare
Healthcare Management
Job Description & How to Apply Below
WPS Health Solutions in Wisconsin is seeking an Appeals Nurse to evaluate medical records for first-level appeal cases, ensuring medical necessity and Medicare coverage alignment. The RN will collaborate with Appeals Examiners to finalize redeterminations within CMS timelines.
The role supports remote work in allowed states and offers a base salary around 66–68k with benefits, including health insurance and 401(k) options. Strong communication and record-review skills are essential.
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