About this role
Clinical Appeals Nurse (Remote | Must have California LVN / RN License) at Alignmenthealthcare. Location: United States or California. Role: reviewing appeals, verifying eligibility, managing cases Requirements: Active California LVN or RN license, minimum 2 years clinical nursing experience, 1 year utilization management/appeals experience preferred, knowledge of clinical criteria and coding (ICD-10, CPT), proficiency with Milliman/InterQual/Apollo, EMR, Word, Excel, and Outlook. Category: Healthcare Services - Nursing Seniority: Entry Level Tools: Milliman, InterQual, Apollo, ICD-10, CPT, Word, Microsoft Excel, Microsoft Outlook, Access Express, N-coder, EHR Certifications: lvn, rn, cphq, abqaurp, six sigma, medical terminology Commitment: Full Time Workplace: Remote Languages: English, Spanish