Appeals Nurse Consultant
Job Description: • Responsible for intake, investigation and resolution of appeals, complaints and grievances scenarios for all products. • Ensure timely, customer focused response to appeals, complaints and grievance. • Identify trends and emerging issues and report and recommend solutions. • Review and resolution of clinical documentation, clinical complaints and appeals. • Independently coordinate the clinical resolution with internal/external clinician support. Requirements: • Experience in reading or researching benefit language. • Excellent verbal and written communication skills. • Excellent customer service skills. • 3-5 years of clinical experience required. • RN with current unrestricted state licensure required. Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs • Confidential counseling and financial coaching • Paid time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical access • Many other benefits depending on eligibility Apply tot his job