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Remote RN Utilization & Appeals Specialist; Medicare​/Medicaid

Remote / Online - Candidates ideally in
Niagara Falls, Niagara County, New York, 14301, USA
Listing for: Phaxis
Per diem, Remote/Work from Home position Listed on 2026-11-07
Job specializations:
  • Nursing
    RN Nurse
Salary/Wage Range or Industry Benchmark: 72000 - 77000 USD Yearly USD 72000.00 77000.00 YEAR

Job Description & How to Apply Below

Position: Remote RN Utilization & Appeals Specialist (Medicare/Medicaid)

Phaxis is seeking an experienced registered nurse for a contract role with a New York health plan. You will own clinical grievances and appeals from intake to final decision letters, applying medical necessity judgments based on Inter Qual/MCG criteria.

The position is 100% remote in the United States, with business hours and occasional evenings or weekends to meet regulatory deadlines. Requires active NY RN license and payer-side experience.

Step into the Remote RN Utilization & Appeals Specialist (Medicare/Medicaid) role at Phaxis in New York, NY, United States and grow with us.

Please review the full job details above before applying.

If your experience matches this role, we encourage you to apply.

All applications are reviewed carefully by our team.

The position is based in New York, NY, United States.

This opportunity is part of our work in Bio & Pharmacology & Health.

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