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.

Join us at WPS Health Solutions as our next Remote Appeals RN for Medicare Medical Necessity in Charleston, SC, United States.

We are currently recruiting a Remote Appeals RN for Medicare Medical Necessity for our team in Charleston, SC, United States.

This is a great opportunity to take on the Remote Appeals RN for Medicare Medical Necessity role at WPS Health Solutions.