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Appeal Nurse Reviewer
Chicago, IL

Apply Now

Posted 6/09/2017

Required Skills

  • BSN and RN (specifically in Illinois)
  • 3-5 years’ experience in a clinical setting
  • Working knowledge of Milliman, InterQual, and / or Apollo
  • Experience with Medicare / Medicaid
  • Experience in a managed care environment

Job Description

  • Investigate and resolve medical appeals for health plan members in both Medicare and Medicaid plans
  • Participate in departmental audits and regulatory site visits

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