Remote Appeals Nurse Medicare Medical Review
Middletown, Butler County, Ohio, 45042, USA
Listed on 2026-09-22
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Nursing
RN Nurse, Clinical Nurse Specialist, Healthcare Nursing, Nurse Educator
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.
We would love to welcome a new Remote Appeals Nurse for Medicare Medical Review to our team in Columbus, OH, United States.
All applications are reviewed carefully by our team.
This is a Full Time role.
The position is based in Columbus, OH, United States.
This opportunity is part of our work in Bio & Pharmacology & Health.
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