What are the responsibilities and job description for the Appeals Nurse Consultant - remote position at The Drexel Group Inc.?
Location: Remote
Pay Rate: $30.00
Hours; 8:30 am - 5:00 pm (Monday - Friday)
Title: QIC Part A Nurse Consultant
Job Description
Essential Duties and Responsibilities:
- Responsible for reviewing favorable and partially favorable determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assesses issues involved in the case.
- Perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Perform other duties as assigned by management.
Minimum Requirements:
- Bachelor's degree with 3-5 years of experience consulting within designated function.
Job Type: Full-time
Pay: $30.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Vision insurance
Education:
- Bachelor's (Required)
Experience:
- Medical necesity determinations: 3 years (Required)
Work Location: Remote
Salary : $30