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Appeals Nurse

Posted By:
Ashleigh Caplan
Posting ID:
Metropolitan New York Area
Category:Medical / Health
Listing Type:Job

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Seeking an Experienced Appeals Nurse. Apply today!

Our client is a pre-paid health care services plan comprised of a network of government-sponsored health care agencies and programs, as well as participating providers, serving New York City and surrounding metropolitan areas. With an expansive and all-inclusive community of general and specialty health care providers, just about everyone who qualifies for government-sponsored health care can gain access to the vast array of low- to no-cost services offered.

Appeals Nurse
Metropolitan New York Area
The Appeals Nurse processes appeals submitted by providers in response to denials generated by our client’s Quality Management Department, and provides retrospective utilization reviews via medial record review.
Qualified candidates will hold an Associate or Bachelor of Science degree in Nursing and possess three or more years of clinical managed care experience. A background emphasizing work with insurance companies during the appeals process is a must. Candidates should also be fully knowledgeable of health care insurance regulations to adequately perform in this role. Candidates must have a background in, and experience with, medical record review. Current New York State licensure as a Registered Nurse is preferred, but not necessary. Besides being technically adept, this individual should have outstanding communication skills.
In addition to a tremendous career opportunity, our client provides generous employee benefits, including full state benefits, a 401(k) plan, a pension plan, and 11 to 12 paid holidays per year. What’s more, they offer a relaxed work environment and embrace diversity (75 languages are spoken). They are very interested in speaking with candidates eager to move up in their careers.
Advance your career with a health services success story! Send your resume and letter of interest, for immediate consideration. Be sure to specify “Appeals Nurse – 36909D” in the subject line.
Our Client is an Equal Opportunity Employer.
RCI Recruitment Solutions is a privately owned firm headquartered in Jupiter, Florida, with operations throughout the United States. For almost 40 years, RCI has provided a wide range of candidate sourcing and related recruitment services. Its proprietary and client-specific solutions encompass a variety of services, including advertising, consulting, media services, and staffing technology.

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