WPS Health Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims for first-level appeals to determine medical necessity and coverage alignment.
The role collaborates with Appeals Examiners to prepare timely redeterminations, document clinical rationales, and ensure compliance with CMS guidelines. A registered nurse with strong communication and attention to detail is essential for success in this fast-paced environment.
#J-18808-LjbffrRemote Appeals Nurse for Medicare Medical Review in columbus at Unknown Company
This position is listed as full time and onsite.