Remote Appeals RN – Florida

Immediate need for a talented Appeals RN. This is a 07 Months Contract opportunity with long-term potential and is located in Florida (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:26-27492

Pay Range: $37 – $42/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• We are seeking a Florida-licensed Registered Nurse with 3+ years of clinical experience and at least 1 year of managed care or utilization management experience.
• The Clinical Appeals Nurse will review appeal requests and medical records, apply InterQual medical necessity criteria, prepare clinical review recommendations, and collaborate with Medical Directors for final determinations.
• Candidates should be self-directed, detail-oriented, and comfortable working remotely.
• Prior authorization, appeals, utilization management, and behavioral health experience are highly preferred.

Key Requirements and Technology Experience:

• Must have skills: – “RN”, “Appeals”, “UM” , InterQual
• Required: Associates OR Bachelors
• Licensure: Preferred: RN
• Years of experience required: At least 3 years in a clinical setting followed by at least 1 year experience in managed care/ utilization management setting such as prior authorization clinical reviewer; appeals clinical reviewer a plus/preferred.

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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