Appeals Nurse Reviewer: Medical Necessity & Compliance
Listed on 2026-10-02
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Nursing
RN Nurse, Clinical Nurse Specialist, Healthcare Nursing, Nurse Educator
Arkansas Blue Cross and Blue Shield is seeking an experienced RN to review appeals of adverse benefit determinations. You will research medical necessity and coverage policy, and exercise independent judgment to ensure fair, compliant decisions.
The role requires an active RN license with 5 years of clinical nursing and at least 2 years in utilization review. You will collaborate with medical divisions and respond to state insurance department complaints.
We have an opening for a Appeals Nurse Reviewer:
Medical Necessity & Compliance in United States within Legal, Management & Operations.
We would love to welcome a new Appeals Nurse Reviewer:
Medical Necessity & Compliance to our group in United States.
For the Appeals Nurse Reviewer:
Medical Necessity & Compliance position at Arkansas Blue Cross and Blue Shield, we are reviewing applications now.
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