Remote Medicare Appeals RN — Clinical Review Expert

WPS Health Solutions is seeking an Appeals Nurse (RN) to review medical records and claims for first-level Medicare appeal cases, assessing medical necessity and adherence to CMS guidelines. The role collaborates with Appeals Examiners to ensure timely redeterminations and compliant processing.

The ideal candidate holds an ASN or BSN and an active RN license, with at least 1 year of clinical experience, strong communication, and solid understanding of medical review processes.

This role, Remote Medicare Appeals RN — Clinical Review Expert at WPS Health Solutions, could be your next career step.

We are seeking a motivated Remote Medicare Appeals RN — Clinical Review Expert to join WPS Health Solutions in Green Bay, WI, United States.

Consider building your career as a Remote Medicare Appeals RN — Clinical Review Expert at WPS Health Solutions.