Remote Appeals Nurse for Medicare Medical Review
Remote / Online - Candidates ideally in
Youngstown, Mahoning County, Ohio, 44501, USA
Listed on 2026-08-15
Youngstown, Mahoning County, Ohio, 44501, USA
Listing for:
WPS Health Solutions
Remote/Work from Home
position Listed on 2026-08-15
Job specializations:
-
Nursing
Job Description & How to Apply Below
WPS Health Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims for first-level appeals to determine medical necessity and coverage alignment.
The role collaborates with Appeals Examiners to prepare timely redeterminations, document clinical rationales, and ensure compliance with CMS guidelines. A registered nurse with strong communication and attention to detail is essential for success in this fast-paced environment.
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