Remote Appeals RN - Medicare Medical Necessity

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

You will review documentation, prepare written letters with rationales, and monitor follow-ups while staying current with healthcare laws and CMS requirements.

We would love to welcome a new Remote Appeals RN
- Medicare Medical Necessity to our team in Kansas City, MO, United States.

The following opening is for a Remote Appeals RN
- Medicare Medical Necessity with WPS Health Solutions.

Our group is growing, and we are hiring a Remote Appeals RN
- Medicare Medical Necessity in Kansas City, MO, United States.

This opening is for the Remote Appeals RN
- Medicare Medical Necessity role at WPS Health Solutions.