California Licensed Clinical Appeals RN
Company: VirtualVocations
Location: Vista
Posted on: May 22, 2025
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Job Description:
A company is looking for a Clinical Appeals RN to work remotely
on post-service appeals for Medicare-based claims.
Key Responsibilities
Review provider post-service appeals for Medicare and
Retirement
Gather clinical information, including medical records and coverage
criteria, per Medicare guidelines
Discuss cases with medical directors and collaborate with other
teams to process cases
Required Qualifications
Undergraduate degree or equivalent experience
Unrestricted, active RN license
2+ years of RN experience in an acute setting
Proven working knowledge of Clinical Criteria and CMS
Guidelines
Demonstrated ability to have a HIPAA compliant home workspace
Keywords: VirtualVocations, Diamond Bar , California Licensed Clinical Appeals RN, Healthcare , Vista, California
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