Massachusetts Licensed RN Appeals Administrator - San Diego California

Company: VirtualVocations
Location: San Diego, California
Posted On: 02/01/2025

A company is looking for an RN Denials and Appeals Administrator, Per Diem.



Key Responsibilities

Manage the pre-denial, denial, and appeal processes in accordance with Utilization Review standards
Utilize medical necessity screening tools to conduct initial and continued stay reviews
Collaborate with payers to secure authorization for clinical services in a timely manner


Required Qualifications

Associate or Bachelor Degree in Nursing; graduate degree preferred
MA RN License is required
CCM or ACM certification preferred
3-5 years of related experience in healthcare case management and patient insurance/billing
3-4 years of supervisory experience preferred More...

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