About this role
Clinical Appeals Coordinator at Wvumedicine. Location: Monongalia County or United States. Role: leading investigations, reviewing records, generating responses Requirements: Current RN or LPN licensure (or multi-state compact), 3+ years clinical claims and appeals experience, 2+ years customer service, proficiency with InterQual/Milliman Care Guidelines and Microsoft Office, strong communication and problem-solving. Category: Healthcare Services - Nursing Seniority: Mid Level Tools: InterQual, Milliman Care Guidelines, Microsoft Office Certifications: registered nurse (rn), licensed practical nurse (lpn), enhanced nurse licensure compact (enlc) Commitment: Full Time Workplace: Remote Languages: English