State Licensed Appeals Nurse
Company: VirtualVocations
Location: Vista
Posted on: May 13, 2025
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Job Description:
A company is looking for an Appeals Nurse to join their
Specialty Appeals Team.
Key Responsibilities
Adhere to company policies and procedures in utilization and
appeals management
Document communications with medical staff and interface with other
departments to resolve appeal-related issues
Provide customer service and collaborate with Clinical Reviewers
for timely adjudication of appeals
Required Qualifications, Training, and Education
1-3 years of experience as a Registered Nurse (RN) - Required
Minimum of 5 years in Utilization Management or healthcare appeals
- Required
Able to work in a rotation from 10:30am to 7pm CST and 8am - 5pm
EST/CST - Required
Preferred ability to exercise independent judgment in clinical
decision-making
Preferred experience with Microsoft Office and strong
organizational skills
Keywords: VirtualVocations, East Los Angeles , State Licensed Appeals Nurse, Healthcare , Vista, California
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