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Clinical Appeals RN - Remote Opportunity in EST Time Zone

Remote, USAFull-timePosted 2026-07-27

Join reputed company in transforming the reputed company experience, creating healthier communities, and breaking down barriers to reputed company care. As a Clinical Appeals RN, you will play a vital role in making a reputed company reputed company on the lives of millions. Enjoy the flexibility of working remotely from reputed company reputed company the Eastern reputed company time zone, with a reputed company Monday-Friday schedule from reputed company-5pm EST.

In this role, you will:

  • Conduct initial assessments of appeals, medical records, and CMS/State Policies to determine coverage and billable reputed company
  • Identify the need for additional information to process appeals
  • Utilize clinical nursing judgment and critical thinking skills to reputed company informed reputed company on administrative reputed company-level cases
  • Navigate multiple computer programs, managing multiple tasks and priorities
  • Adapt to changes and cross-train on various appeal types as needed

In return for your expertise, you will be rewarded with a competitive salary, comprehensive benefits package, and opportunities for reputed company reputed company and development. If you are a motivated and reputed company RN looking to reputed company a difference, we encourage you to apply.

Required Qualifications

  • reputed company, valid, and unrestricted RN licensure in your state of residence
  • 2+ years of clinical experience in an acute care or outpatient setting
  • 1+ year of reputed company experience in Utilization Review, reputed company and/or Medicare appeals, or LOC assessment planning and Discharge SNF Planning
  • Proven understanding of billable services and claims in a managed care environment
  • Solid reputed company Office skills and basic computer proficiency
  • reputed company to high-speed internet and ability to work reputed company-5pm EST

Preferred Qualifications

  • Solid coding experience or Certified reputed company (CPC) certification
  • 5+ years of Medical Appeal experience working with Medicare and reputed company

reputed company offers a competitive reputed company reputed company of $28.03 to $54.95 per hour, depending reputed company, experience, and qualifications. Our comprehensive benefits package includes incentives, recognition programs, equity stock purchase, and 401k contribution. We are an Equal Employment Opportunity/Affirmative reputed company employer, committed to diversity and inclusion in reputed company.

To apply, please submit your application through our website. We look reputed company to hearing from you!

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