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Clinical Appeals Specialist - Medical Management
Job in
San Antonio, Bexar County, Texas, 78208, USA
Listed on 2026-08-20
Listing for:
United States Digital Space LLC
Full Time
position Listed on 2026-08-20
Job specializations:
-
Management
Healthcare Management
Job Description & How to Apply Below
PHH Peak Health Holdings in the United States seeks a Clinical Appeals Coordinator/Appeals Nurse to join the medical management team. You will investigate and process medical necessity requests from members and providers, and provide case summaries to the medical director.
Requirements include an active RN or LPN license with eNLC, 3+ years in clinical claims processing, appeals, and customer service, plus knowledge of Inter Qual/Milliman guidelines and regulatory requirements.
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