Hospitals And Health Care
New York, NY Apply Now Practice Interview
* This job might be expired as it was posted more than a month ago.
RN Appeals Nurse at VillageCare
Description
Appeals Nurse VillageCareMAX 112 Charles Street, New York, NY 10014 Responsibilities VillageCare is looking for a self-motivated and passionate RN for our Appeals Nurse position.
While supporting the Utilization Management team, the Appeals Nurse will conduct comprehensive analytic reviews of clinical documentation.
This dynamic role will allow you to use your clinical knowledge to make authorization decisions, and assist with appeal determinations.
Some of your responsibilities will include the following: Collect information concerning eligibility, provider status, benefit coverage, coordination of benefits and subrogation necessary to reach prospective, concurrent and retrospective decisions in the appeals process.
Review and interpret a variety of instructions and medical notes furnished in written and oral form to determine appropriate action towards appeal.
Write sound, factual, clinical arguments and attend Administrative Law Judge hearings for warranted appeals.
Detect problems, recognize important information, and link various data will be vital to this position.
We would like to speak to those who have a current unrestricted NYS RN license to practice professional nursing.
- Role: RN Appeals Nurse
- Company: VillageCare
- Location: New York, NY
- Job found on: 10th of September, 2025
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Apply Now
Practice Interview
* This job might be expired as it was posted more than a month ago.
