Job Description

Remote Rn Appeals Reviewer

Adecco Healthcare & Life Sciences is hiring remote RN Appeals Reviewers! This role is remote / work from home. Please read below and apply with an updated resume for consideration:

Type: Four-month contract, opportunity for extension or fulltime offer

Schedule: Forty hours per week, eight-hour days

Pay: $40.50 to $42.50 an hour

Responsibilities Of The Rn Appeals Reviewer:

• Responsible for conducting thorough reviews of member and provider appeals, analyzing claim adjustments and histories, and reviewing previous decisions.
• Evaluate denied services in accordance with policies, benefit plans, federal and state regulations, and clinical criteria, rendering approvals when appropriate.
• You will summarize medical information for review by the Medical Director as needed, ensuring a balance between high-quality work and meeting production goals.

Qualifications For The Rn Appeals Reviewer:

• Associates degree
• Active and good standing RN license in state of residence
• 5+ years of clinical experience as an RN, including in an acute, inpatient hospital setting
• Experience applying benefits and criteria to clinical reviews
• Utilization Management, pre-authorization, concurrent review, or appeals experience

Why work for Adecco?

Weekly Pay

401(k) Plan

Skills Training

Excellent medical, dental, and vision benefits

Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.

Equal Opportunity Employer/Veterans/Disabled Military connected talent encouraged to apply

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