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WPS Health Solutions is seeking an Appeals Nurse to review medical records and claims for first-level appeals to determine medical necessity under Medicare guidelines. The role collaborates with Appeals Examiners/Reps to ensure timely redeterminations are medically reviewed and completed.
A valid RN license and 1+ year clinical experience are required, with remote work options available in approved states. The position offers a competitive salary range of 66–68k with a base pay that may vary by
WPS Health Solutions is seeking an Appeals Nurse to review medical records and claims for first-level appeals to determine medical necessity under Medicare guidelines. The role collaborates with Appeals Examiners/Reps to ensure timely redeterminations are medically reviewed and completed.
A valid RN license and 1+ year clinical experience are required, with remote work options available in approved states. The position offers a competitive salary range of 66–68k with a base pay that may vary by