About this role
Clinical Appeals Nurse (Remote) at CareFirst BlueCross BlueShield. Location: Baltimore, Maryland, United States. Role: investigating appeals, organizing cases, preparing responses Requirements: Active RN state or compact license required, 3+ years clinically related experience in medical review/utilization management, BSN or equivalent experience, CCM preferred, knowledge of medical terminology, regulatory requirements, and Microsoft Office. Category: Healthcare Services - Nursing Seniority: Mid Level Tools: Microsoft Office, MCG, InterQual Certifications: rn, ccm, certified coder Commitment: Full Time Workplace: Hybrid Languages: English