Registered Nursing (RN) - Appeal Analyst I
Careers Integrated Resources Inc
Atlanta, GA(remote)
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JOB DETAILS
SKILLS
Analysis Skills, Claims Processing, Clinical Medicine, Communication Skills, Computer Skills, Health Insurance, Hospital, Microsoft Excel, Microsoft Word, National Committee for Quality Assurance (NCQA), Patient Care, Presentation/Verbal Skills, Registered Nurse (RN), Utilization Management, Utilization Review Accreditation Commission (URAC), Writing Skills
LOCATION
Atlanta, GA
POSTED
2 days ago
Title: Registered Nursing (RN) - Appeal Analyst I
Location: NJ ,CT ,DE , PA, NY ( Fully Remote)
Contract: 13+ Weeks Contract (Possibility of Extension)
Job Summary:
- Appeal Analyst RN who will train new hire in the clinical role to complete Utilization Management Appeals and act as an RN II on the team.
Required Experience:
- Knowledge of accreditation, i.e. URAC, NCQA standards and health insurance legislation. Awareness of claims processes and claims processing systems.
- PC proficiency to include Microsoft Word and Excel and health insurance databases.
- Verbal and written communication skills with ability to communicate to physicians, members and providers and compose and explain document findings.
- Organizational skills and prioritization skills
- Registered Nurse (RN) with unrestricted license in NJ state.
- 3 years clinical experience with at least
- 2 years within the hospital setting or direct patient care.
About the Company
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