Remote Appeals Nurse — Medicare Medical Necessity Expert

WPS Health Solutions seeks an Appeals Nurse (RN) to review medical records for first-level appeal cases to determine medical necessity under Medicare guidelines. You will collaborate with Appeals Examiners to ensure timely redeterminations and proper documentation.

Requirements include ASN/BSN, active RN license, 1+ year clinical experience, and strong communication and organizational skills. Remote work is available for designated states, with competitive benefits and 401(k) matching.

This is a strong role to take on the Remote Appeals Nurse — Medicare Medical Necessity Expert role at WPS Health Solutions.

As a Remote Appeals Nurse — Medicare Medical Necessity Expert, you will play an important part at WPS Health Solutions in Omaha, NE, United States.

We invite applications for the Remote Appeals Nurse — Medicare Medical Necessity Expert position located in Omaha, NE, United States.