Employer Industry: Healthcare Services

Why Consider this Job Opportunity:
- Salary up to $66.25 per hour
- Opportunity for career advancement and growth within the organization
- Remote work flexibility for Pacific or Mountain Time Zone residents
- Comprehensive benefits package including equity stock purchase and 401k contribution
- Chance to make a positive impact on patient care and health outcomes

What to Expect (Job Responsibilities):
- Process denial-related and member-oriented communications in a timely manner
- Serve as a liaison for internal and external customer communication
- Document and communicate appeal and denial information
- Complete appeal and denial processes in accordance with guidelines
- Assist with pre-service authorization requests and other duties as assigned

What is Required (Qualifications):
- High School Diploma / GED
- 3+ years of clinical experience
- Active, unrestricted registered clinical license (RN, PT, OT, or ST)
- Understanding of market variability related to denial process and CMS regulations
- Experience with Windows and Microsoft Office suite

How to Stand Out (Preferred Qualifications):
- Managed care or case management experience
- Experience with appeals and/or denials processing
- ICD-10, InterQual experience, and CMS knowledge
- Compact Nursing License or multiple state licensures for RNs
- Compact Licensure or multiple state licensures for Physical Therapy

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