Remote Appeals Nurse: Medicare Medical Necessity Expert

WPS Health Solutions is seeking an Appeals Nurse (RN) to review medical records and claims information for first-level appeal cases, determining medical necessity under Medicare guidelines. You will collaborate with Appeals Examiners to ensure redeterminations are medically reviewed and completed timely.

The role requires an active RN license (ASN/BSN), 1+ year clinical experience, strong communication and meticulous organizational skills, and the ability to work remotely from approved states.

We invite applications for the Remote Appeals Nurse:
Medicare Medical Necessity Expert position located in Atlanta, GA, United States.

Take a moment to read everything above and see whether this role is right for you.

This posting is for the Remote Appeals Nurse:
Medicare Medical Necessity Expert role at WPS Health Solutions, based in Atlanta, GA, United States.

We are looking to fill the Remote Appeals Nurse:
Medicare Medical Necessity Expert position at WPS Health Solutions in Atlanta, GA, United States.