Job Title: Utilization Management / Appeals RN
Must have BSN***
Location: Onsite required; offices in either Lake Success or Albany, NY
Hours: M-F 8-5
Start date: ASAP, looking to get all RNs started together
Pay: $48-54/hr+ (negotiable)
Experience: UM, Appeals, or strong clinical and analytical background to do claims adjudication.
Volume: Will do appeals work under the IDR team handling on average 10 cases a day. These will be a mix between simple and complex cases. They will be reviewing documentation, codes, and more for out of Network bills and cost and making determinations on how to move forward based on the evidence.
