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Remote Appeals Nurse: Medicare Case Reviewer
Remote / Online - Candidates ideally in
Hopkinsville, Christian County, Kentucky, 42241, USA
Listed on 2026-08-15
Hopkinsville, Christian County, Kentucky, 42241, USA
Listing for:
WPS—A health solutions company
Remote/Work from Home
position Listed on 2026-08-15
Job specializations:
-
Nursing
Healthcare Nursing
Job Description & How to Apply Below
WPS Health Solutions is seeking an Appeals Nurse to review medical records and claims for first-level Medicare redeterminations to determine medical necessity and coverage alignment. You will collaborate with Appeals Examiners/Reps to ensure timely, accurate determinations and required documentation is prepared for CMS and internal policies.
The role requires an RN license, ASN/BSN, and 1+ year clinical experience, with strong communication and attention to detail.
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