Remote Appeals RN Medicare Medical Necessity

WPS Health Solutions is seeking an Appeals Nurse (RN) to review medical records and claims for first-level appeal cases to determine medical necessity and compliance with Medicare guidelines. You will collaborate with Appeals Examiners to ensure timely redeterminations and quality outcomes.

The role supports remote work in multiple states and offers a base salary of 66–68k with performance-based opportunities. Ideal candidates have an active RN license and 1+ year of clinical experience.

This Full Time position is for the Remote Appeals RN for Medicare Medical Necessity role at WPS Health Solutions.

Are you ready to take on the Remote Appeals RN for Medicare Medical Necessity role at WPS Health Solutions?

We would love to welcome a new Remote Appeals RN for Medicare Medical Necessity to our organisation in Charleston, SC, United States.